Application of Using Gore Preclude MVP Dura Substitute for Intraoperative Durotomy Repair in Lumbar Spine Surgery: Case Series and A Technical Note

Abstract

AbstractDurotomy is an intraoperative complication in lumbar surgery, which can result in refractory cerebrospinal leakage. Therefore, intraoperative durotomy in lumbar surgery should be appropriately repaired. The aim of the study was to describe our method to repair intraoperative durotomy using the Gore Preclude MVP Dura Substitute (MVP). The MVP is an artificial dural substitute of three layers. Its surfaces are composed of expanded polytetrafluoroethylene, and the intermittent layer is made of a proprietary fluoroelastomer. After an incidental durotomy during surgery, the MVP was cut and designed bigger than the size of the durotomy site. The MVP was inserted into the space between the dura and the arachnoid membrane. The MVP was unfolded in the inserted space and fixed to the dura using four nodes of 6–0 nylon yarn. Intraoperative dural repair was achieved, and cerebrospinal fluid leakage did not persist. No complications were observed. Our method to repair intraoperative durotomy using the MVP can be simple and useful.