Selling Dural Grafts to Spine and Cranial Surgeons: Two Conversations

Spine and cranial surgeons both use dural grafts, but for different reasons. A cranial surgeon usually plans a duraplasty as part of the operation. A spine surgeon often meets a dural tear as an unwanted event in the middle of a case. A rep who opens both conversations the same way will lose one of them.

This article is for independent agencies and distributors who call on both specialties. It breaks down what each surgeon is likely to care about, the questions you should be ready for, and how DESU's two collagen dural grafts fit each setting. It is not about mapping demand or forecasting volume; it is about what to say in the room.

Why are the two conversations different?

In cranial surgery, the dura is opened deliberately. The surgeon knows before the first incision whether a graft may be needed: after a tumor resection that includes a dural attachment, in a posterior fossa decompression, in a trauma case where the brain is swollen, or when the native dura is too thin or retracted to close primarily. The graft is part of the plan.

In spine surgery, the dura is usually meant to stay closed. A durotomy can happen during a decompression, a revision through scar, or the removal of an ossified ligament. When it does, the surgeon needs a reliable repair quickly, often in a narrow field with limited exposure. Intradural spine surgery is the exception, where the opening is planned and closure is part of the operation.

That difference shapes everything else: when the surgeon thinks about the graft, how much time they want to spend on it, and what they value in the product.

What does a cranial surgeon want to know?

Cranial surgeons tend to be precise about technique. Many have strong views on whether a graft should be sutured, laid as an onlay, or combined with a sealant. Your opening question should be about their usual closure, not about your product.

• How do you usually close after a convexity tumor resection, and when do you reach for a graft?
• Do you prefer to suture the graft, or do you use onlay technique when the defect allows it?
• Which sizes do you need most often, and do you trim from larger sheets?
• How do you handle the posterior fossa, where watertight closure is often harder to achieve?
• What do you dislike about the graft you use today?

The answers tell you which DESU product to put in front of them. A surgeon who sutures will want to see DURASHEET, which is suturable and usable on both surfaces. A surgeon who favors onlay repair for suitable defects will want to see DECOLL. Many cranial surgeons use both techniques, depending on the case.

What does a spine surgeon want to know?

Spine surgeons often think about dural repair only when they need it. Their concerns are practical: is a suitable graft in the room, can it be handled in a deep and narrow exposure, and will it fit alongside the primary repair they already do?

• Is the graft on the shelf in the spine OR, or only in the neuro room down the hall?
• Can it be placed through the exposure the surgeon actually has?
• Does it work with the suture technique and sealant they already use?
• Is a small size available, so a large sheet does not have to be opened for a small tear?
• Who brings it in, and how quickly, if the hospital has not stocked it yet?

For many spine surgeons, availability is the first selling point. If the product is not in the room when the tear happens, the best handling characteristics in the world do not matter. The rep who helps the hospital stock the right sizes in the right OR wins the account.

How should you structure each first meeting?

The structure below has worked well for agencies covering both specialties. It keeps the conversation short and specific.

The table is a starting point, not a script. Listen more than you speak, and let the surgeon tell you which problem matters.

How do you answer "we rarely need it" in spine?

This is the most common objection in spine practices, and it deserves a respectful answer. Incidental durotomy is a known part of spine surgery, and every spine surgeon has a plan for it. The question is whether that plan includes a graft that is immediately available when primary repair alone is not enough.

Frame the product as preparedness. A small stock of ready-to-use, gamma-sterilized grafts in the spine OR means the surgeon does not have to wait for a graft to be found, or improvise. That is a supply-chain argument as much as a clinical one, and it is one that OR managers and value-analysis teams understand.

It also helps to ask how the last tear was handled. If the answer involves waiting, borrowing a graft from another room or opening a large sheet for a small defect, the surgeon has just described the problem your product solves. Let them make the case in their own words, then offer a stocking proposal for the sizes they would actually use.

What should you avoid saying to either surgeon?

Both specialties are allergic to overstated claims, and with good reason. A dural graft is one part of a repair. It does not, by itself, decide whether a patient develops a CSF leak or a pseudomeningocele. Surgical technique, patient factors and wound closure all matter.

• Do not claim the graft will stop leaks; say it is designed to support dural repair.
• Do not compare outcomes with other products unless you have published data to point to.
• Do not suggest a technique the surgeon has not asked about; offer the product that fits their technique.
• Do not guess at specifications; check the IFU and the DESU catalog.

Honest, specific information builds trust faster than enthusiasm. Surgeons remember the rep who answered a question precisely, or who said "I will find out" and came back the next day with the answer from the manufacturer.

How does the manufacturer support both conversations?

DESU designs and manufactures its dural grafts in its own cleanrooms in Ankara, Türkiye, under an ISO 13485 quality system, and its products carry the CE mark. For a rep, the practical benefit is direct access: questions about the material, the sterilization method or the documentation go to the people who make the product.

DESU's wider portfolio also helps. The same cranial surgeon who uses a dural graft is likely to place external ventricular drains and shunts, and DESU manufactures those as well. A rep covering spine may find related needs in collagen bone grafts. Our article on incidental durotomy and graft selection goes deeper into the spine case.

Talk to a DESU product specialist

If your agency calls on spine and cranial surgeons and you want to add a collagen dural graft line, DESU's product specialists can help you prepare both conversations, share product documentation and discuss what your market requires. Contact sales@desu.tr, use the contact page, or request a quote.