Dural sealants for the management of cerebrospinal fluid leakage after intradural surgery: current status and future perspectives

Abstract

Introduction: Cerebrospinal fluid leakage is a complication after intradural surgery and is associated with severe secondary complications like compromised wound healing and meningitis. Dural sealants are meant to augment the primary dural closure in order to achieve a watertight closure. Areas covered: This review summarizes the efficacy of currently available dural sealants. Potential future improvements and biomaterials are discussed. Expert opinion: The use of a dural sealant seems to be the logical method to prevent CSF leakage. However, based on the efficacy of currently available dural sealants according to systematic reviews and in vitro studies, a significant effective dural sealant seems is still lacking. A new dural sealant has to be thoroughly assessed before clinical application in in vitro, in vivo and clinical trials. A new research area within sealant development might be the introduction of dural sealants with both antimicrobial and analgesic properties.

Keywords: Cerebrospinal fluid leakage; biomaterials; craniotomy; spinal surgery.