Operative Neurosurgery 28:379–385, 2025
This study compares microsurgical suturing and patch-sealing techniques for repairing ventral cerebrospinal fluid leaks in spontaneous intracranial hypotension. Both methods are equally effective, but sealing is faster and involves less spinal cord manipulation, potentially reducing surgical complications.
Study Overview and Methods
• Compared microsurgical suture vs. patch-sealing for ventral dural leaks in SIH patients.
• Retrospective analysis conducted between 2013 and 2023 at a single center.
• 85 patients with Type 1 SIH leaks were included in the study.
Results
• No significant difference in headache resolution between techniques (89% vs 94%).
• Sealing technique was significantly faster than suturing (139 vs 169 minutes).
• Complication rates: 23% in suture group, 9% in sealing group (not statistically significant).
Clinical Outcomes
• No significant difference in postoperative Bern-Score between techniques.
• SLEC-positive postoperative rate: 13% in suture group, 22% in sealing group.
• 90% of patients reported headache improvement post-surgery.
Discussion
• Both techniques are effective, but sealing minimizes spinal cord manipulation.
• Sealing preferred due to faster surgery time and fewer complications.
• Limitations include retrospective design and potential selection bias.
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