Primary Dural Closure in Minimally Invasive Spine Surgery Using an Extracorporeal Knot: Technical Note.

BACKGROUND: Minimally invasive spine surgeries (MISS) are currently used for a wide variety of intradural spinal pathologies. Although MISS techniques have brought great benefits, primary dural closure can prove a challenge due to the narrow corridor of the tubular retractor systems. OBJECTIVE: To present the surgical technique we developed for dural closure using an extracorporeal knot that is simple and reproducible. METHODS: We describe the use of an extracorporeal knot for primary dural closure in MISS surgeries using standard instrumental. We illustrate this operative technique with figures and its application in a surgical case with images and demonstration video2. RESULTS: Using our surgical technique, a watertight dural closure with separated knots was performed without specific instruments. CONCLUSION: The use of extracorporeal knots facilitates primary dural closure in MISS surgeries.