The use of titanium non-penetrating clips to close the spinal dura

Abstract

We present the results of our initial experience in the use of non-penetrating titanium clips in the closure of spinal dura. A retrospective analysis of case notes of patients identified from the unit database was carried out, limited to adults. A proforma that included demographic details, the diagnosis, the procedure undertaken, whether or not additional dural closure methods were used, the use of bed rest and any complications, including cerebrospinal fluid (CSF) leak. There were 58 patients with a mean age of 53 years. The commonest diagnoses were meningioma, ependymoma and neurofibroma. Eight patients had additional methods of dural closure used and approximately half the patients had a period of postoperative bed rest. Eight patients (13.7%) had a CSF leak. Our early experience with the use of non-penetrating clips for the closure of the spinal dura is presented. We have found them easy to use, especially in anatomically-restricted spaces and rapid in their application. However, our results have revealed an unexpectedly high complication rate. A further prospective study to evaluate them more fully is planned.

Key words:

• Dura mater
• duraplasty
• sutures
• titanium clips