TY - JOUR
T1 - Use of TachoSil for durotomy repair in spine surgery
T2 - a single-center retrospective review
AU - Chaliparambil, Rahul K.
AU - Kemeny, Hanna R.
AU - Mukherjee, Shreya
AU - Krushelnytskyy, Mykhaylo
AU - Wolinksy, Jean Paul
AU - Swong, Kevin
AU - Dahdaleh, Nader S.
AU - Ahuja, Christopher S.
AU - Tecle, Najib E.El
N1 - Publisher Copyright:
©AANS 2025, except where prohibited by US copyright law
PY - 2025
Y1 - 2025
N2 - OBJECTIVE A significant complication of spine surgery is persistent postoperative CSF leak secondary to intentional or incidental durotomy. Traditionally, the gold standard for repair of simple durotomy has been primary surgical repair; however, this technique alone may not be possible for more complex durotomy and is often supplemented with sealants or fibrin glues. The authors add to the literature the largest series of spine surgery patients treated with TachoSil, a syn- thetic collagen patch containing human fibrinogen and human thrombin, for the management of incidental or intentional durotomy. METHODS The authors identified all patients who underwent a spinal operation and were billed for operative use of TachoSil at their institution between January 1, 2023, and November 3, 2023. Demographic, clinical, and outcome vari- ables were collected and analyzed using standard statistical methods. Categorical variables were reported as number (%), and continuous variables were reported as median (range). RESULTS The authors retrieved 55 patients meeting their inclusion criteria. The population consisted of 29 (52.7%) fe- males, had a median age of 52 years, and had a median BMI of 28.3 kg/m2. Of the repaired durotomies, 37 (67.3%) were intentional to the operation and 18 (32.7%) were incidental or secondary to trauma. Abnormal residual fluid collections were appreciated in 1 (1.8%) patient. Wound breakdown was observed in 2 (3.6%) patients. Thirty-day readmission was observed in 6 (10.9%) patients, and 30-day reoperation was necessary in 2 (3.6%) patients. Ninety-day readmission was observed in 7 (12.7%) patients and 90-day reoperation was necessary in 3 (5.5%) patients. One (1.8%) case of 30-day readmission was related to CSF leak, and no cases of 30-day or 90-day reoperation were related to dural closure failure. CONCLUSIONS This study is a brief examination of the demographic characteristics, surgical variables, and outcomes of durotomy repair in spine surgery with TachoSil and provides encouraging results for the continued use of the material in this context. This study provides the impetus for examination of TachoSil in larger, multi-institutional studies to estab- lish it as a standard of care in spinal dural repair.https://thejns.org/doi/abs/10.3171/2024.11.FOCUS24667
AB - OBJECTIVE A significant complication of spine surgery is persistent postoperative CSF leak secondary to intentional or incidental durotomy. Traditionally, the gold standard for repair of simple durotomy has been primary surgical repair; however, this technique alone may not be possible for more complex durotomy and is often supplemented with sealants or fibrin glues. The authors add to the literature the largest series of spine surgery patients treated with TachoSil, a syn- thetic collagen patch containing human fibrinogen and human thrombin, for the management of incidental or intentional durotomy. METHODS The authors identified all patients who underwent a spinal operation and were billed for operative use of TachoSil at their institution between January 1, 2023, and November 3, 2023. Demographic, clinical, and outcome vari- ables were collected and analyzed using standard statistical methods. Categorical variables were reported as number (%), and continuous variables were reported as median (range). RESULTS The authors retrieved 55 patients meeting their inclusion criteria. The population consisted of 29 (52.7%) fe- males, had a median age of 52 years, and had a median BMI of 28.3 kg/m2. Of the repaired durotomies, 37 (67.3%) were intentional to the operation and 18 (32.7%) were incidental or secondary to trauma. Abnormal residual fluid collections were appreciated in 1 (1.8%) patient. Wound breakdown was observed in 2 (3.6%) patients. Thirty-day readmission was observed in 6 (10.9%) patients, and 30-day reoperation was necessary in 2 (3.6%) patients. Ninety-day readmission was observed in 7 (12.7%) patients and 90-day reoperation was necessary in 3 (5.5%) patients. One (1.8%) case of 30-day readmission was related to CSF leak, and no cases of 30-day or 90-day reoperation were related to dural closure failure. CONCLUSIONS This study is a brief examination of the demographic characteristics, surgical variables, and outcomes of durotomy repair in spine surgery with TachoSil and provides encouraging results for the continued use of the material in this context. This study provides the impetus for examination of TachoSil in larger, multi-institutional studies to estab- lish it as a standard of care in spinal dural repair.https://thejns.org/doi/abs/10.3171/2024.11.FOCUS24667
KW - CSF leak
KW - TachoSil
KW - durotomy
KW - intradural spine surgery
KW - spine surgery
UR - http://www.scopus.com/inward/record.url?scp=85217149801&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85217149801&partnerID=8YFLogxK
U2 - 10.3171/2024.11.FOCUS24667
DO - 10.3171/2024.11.FOCUS24667
M3 - Article
C2 - 39891932
AN - SCOPUS:85217149801
SN - 1092-0684
VL - 58
SP - E12-E12
JO - Neurosurgical focus
JF - Neurosurgical focus
IS - 2
ER -