• Nam Han Ga Wi HGW Department of Neurosurgery, Good Doctor Teun Teun Hospital, Anyang, Korea., Hyung Suk Kim, Jin Soo Park, Dong Keun Lee, Chun-Kun Park, and Kang Taek Lim.
• Department of Neurosurgery, Good Doctor Teun Teun Hospital, Anyang, Korea.
• World Neurosurg. 2018 Dec 1; 120: 448-456.

BackgroundIncidental durotomy (ID) during surgery for lumbar herniated disks or lumbar spinal stenosis is a serious complication that requires immediate recognition and repair. The incidence of ID during percutaneous endoscopic lumbar decompression has increased along with the demand for endoscopic spinal surgery. The management of ID during endoscopic surgery is more complicated and difficult than management during open surgery. A hemostatic agent, TachoSil (Nycomed, Linz, Austria), is used for control of local bleeding in several types of surgery, but its use in dural repair in endoscopic spinal surgery has not been described.Case DescriptionWe present 3 cases in which the double-layer TachoSil packing technique was used in the management of ID during percutaneous stenoscopic lumbar decompression.ConclusionsThis case report reconfirms the efficacy and utility of TachoSil for IDs that occur during endoscopic spinal surgery and minimally invasive surgery. To our knowledge, this is the first report on the use and effectiveness of TachoSil for managing IDs during endoscopic spinal surgery. We hope that other surgeons will find this technique helpful in managing IDs.Copyright © 2018. Published by Elsevier Inc.

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