Innovative Biomaterials for Incidental Durotomy During Spinal Surgery: Review of Modern Management of CSF Leaks

Introduction: Incidental durotomies are a common complication of spinal surgery that can result in worse outcomes like intracranial hypotension and subdural hematoma. Traditional methods like direct suturing and fibrin products have been used for intraoperative repair, but they are not without flaws. There has been a rise in new biomaterials and techniques along with a variety of new uses for previously hemostatic products to address durotomy repair. This article discusses the novel methods and off-label products used for durotomy repair including, but not limited to, Durastat, TachoSil, and surgical clips.

Methods: We conducted a rapid review to evaluate novel methods and off-label products used in durotomy repair. A systematic search was performed across key medical databases, including PubMed and Embase, focusing on clinical trials and case reports that assess the efficacy, biocompatibility, or safety of Durastat, Tachosil, surgical clips, or similar materials for durotomy repair.

Results: We focus on the efficacy, biocompatibility, and safety of these techniques along with long-term outcomes using randomized control trials and case studies.

Conclusion : The novel methods explored in this paper indicate the need for further clinical studies exploring their efficacy with the potential to revolutionize incidental durotomy repair.