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Study on the Role of Non Penetrating Titanium Clips in Dural Repair

Author(s): Naveenkumar kuppan, Dr. Krishnakumar R

Study design: A Prospective study. Objective: Dural injuries (Durotomy) are a common complication often seen in spine surgeries. Primary repair of dura using conventional techniques with sutures (silk or prolene) is considered gold standard in management.

Overview of Literature: The use of Non-penetrating Titanium clips as an alternate for the sutures in Dural closure has been described in literatures. The surgical use of titanium clips alone for the primary repair of dura in spine surgeries is yet to be substantiated. Aim of this study is to assess the role of non-penetrating Titanium clips in Dural repair surgeries.

Methods: This is a study conducted from November 2017 to July 2019 involving a total of hundred forty one spine patients. Thirty seven patients who had undergone spinal epidural steroid injections and scoliosis surgeries were excluded from the study. Of the hundred and four cases, fifteen cases had undergone Dural repair. Non-penetrating Titanium clips were applied in five of the cases.

Results: Among the five cases, three were female and two male patients. Three cases undergone spinal decompression and fusion, one case of microdiscectomy and one case of intradural extramedullary tumor excision. Size of Dural tear range from 0.5 cm to 3 cm. The number of clips applied ranges from one to fifteen numbers. Among the study group, four patients had a smooth post-operative period without any signs and symptoms. One patient who had undergone intradural tumor excision, developed post-operative wound leakage and postural headache.

Conclusion: Non-penetrating titanium clips produce complete Dural closure with no suture holes. We conclude non-penetrating clips can be used as an alternative for conventional sutures for durotomy repair.

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