Pressure-modulated dural repair during unilateral biportal endoscopic spine surgery: technique description and preliminary feasibility report.
4 affiliations
- 1Graduate Institute of Medical Sciences, College of Medicine, National Defense Medical University, Taipei, Taiwan.
- 2Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
- 3Graduate Institute of Pharmacology, College of Pharmacy, National Defense Medical University, Taipei, Taiwan.
- 4Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
Abstract
The clinical management of incidental durotomy during the performance of endoscopic spine surgery presents a significant clinical challenge. Instrument maneuverability is limited, and the unique aqueous environment that introduces complications secondary to the intradural influx of irrigation fluid. The purpose of this study was twofold: first, to describe in detail a novel water-pressure modulation technique for collagen matrix inlay graft placement for incidental durotomy repair during unilateral biportal endoscopic spine surgery (UBES); and second, to evaluate the efficacy of this technique in three specific clinical cases, focusing on its feasibility and safety. This retrospective study was conducted on clinical cases involving patients who underwent UBES for degenerative lumbar spine pathology from September 2022 to September 2024, based on a review of medical records. Surgical documentation was rigorously examined to ascertain occurrence of incidental durotomy during UBES. The clinical characteristics associated with the durotomy were systemically documented alongside the specific repair technique employed. A total of three incidental durotomies were identified from 91 UBES procedures performed, resulting in an incidence rate of 3.29%. In each case, the incidental durotomy was successfully repaired through the modulation of irrigation pressure to facilitate the placement of a collagen matrix inlay graft. No patients experienced postoperative cerebrospinal fluid leak or required revision surgery. Analysis of these clinical cases demonstrated the technical feasibility and preliminary safety of irrigation pressure modulation for collagen matrix inlay graft placement for incidental durotomy repair during UBES. However, further studies with a larger sample size are required to confirm these findings.
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BibTeX
@article{lin2026pressuremodulated,
title = {{Pressure-modulated dural repair during unilateral biportal endoscopic spine surgery: technique description and preliminary feasibility report.}},
author = {Bon-Jour Lin and Hao-Yuan Hung and Kuan-Yin Tseng and Dueng-Yuan Hueng and Yuan-Hao Chen and Da-Tong Ju and Hsin-I Ma and Ming-Ying Liu and Hong-Jaan Wang},
journal = {Frontiers in surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1955075},
url = {https://europepmc.org/article/MED/42952591},
note = {CC BY},
}
RIS
TY - JOUR
TI - Pressure-modulated dural repair during unilateral biportal endoscopic spine surgery: technique description and preliminary feasibility report.
AU - Bon-Jour Lin
AU - Hao-Yuan Hung
AU - Kuan-Yin Tseng
AU - Dueng-Yuan Hueng
AU - Yuan-Hao Chen
AU - Da-Tong Ju
AU - Hsin-I Ma
AU - Ming-Ying Liu
AU - Hong-Jaan Wang
PY - 2026
DA - 2026/10/14
JO - Frontiers in surgery
DO - 10.3389/fsurg.2026.1955075
UR - https://europepmc.org/article/MED/42952591
AB - The clinical management of incidental durotomy during the performance of endoscopic spine surgery presents a significant clinical challenge. Instrument maneuverability is limited, and the unique aqueous environment that introduces complications secondary to the intradural influx of irrigation fluid. The purpose of this study was twofold: first, to describe in detail a novel water-pressure modulation technique for collagen matrix inlay graft placement for incidental durotomy repair during unilateral biportal endoscopic spine surgery (UBES); and second, to evaluate the efficacy of this technique in three specific clinical cases, focusing on its feasibility and safety. This retrospective study was conducted on clinical cases involving patients who underwent UBES for degenerative lumbar spine pathology from September 2022 to September 2024, based on a review of medical records. Surgical documentation was rigorously examined to ascertain occurrence of incidental durotomy during UBES. The clinical characteristics associated with the durotomy were systemically documented alongside the specific repair technique employed. A total of three incidental durotomies were identified from 91 UBES procedures performed, resulting in an incidence rate of 3.29%. In each case, the incidental durotomy was successfully repaired through the modulation of irrigation pressure to facilitate the placement of a collagen matrix inlay graft. No patients experienced postoperative cerebrospinal fluid leak or required revision surgery. Analysis of these clinical cases demonstrated the technical feasibility and preliminary safety of irrigation pressure modulation for collagen matrix inlay graft placement for incidental durotomy repair during UBES. However, further studies with a larger sample size are required to confirm these findings.
SN - 2296-875X
ER -