Full endoscopic treatment of dural tears in lumbar spine surgery

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Joachim M Oertel, Benedikt W Burkhardt

Abstract

An incidental durotomy is a common complication of spinal surgery. Its treatment remains challenging, especially in endoscopic procedures. The objective of this study is to describe a technique for endoscopic dural closure which is safe and effective. From a prospective database all endoscopic spinal procedures with incidental durotomy were identified. Retrospectively, video recordings were analysed with a special reference to the applied technique of dural closure. Additionally 1, 6 and 12 week follow-up examinations were evaluated for clinical outcome and associated complications. Out of 212 consecutive patients, an intraoperative dural tear was observed in nine patients (4.2%). A dural tear occurred in 1.1% of cases of lumbar disc herniation, in 7.9% of cases with lumbar spinal stenosis, in 37.5% of cases with a synovial cyst. An autologous muscle sample was harvested within the operative field and grafted at the dural defect in several layers. Fixation of the transplantation and watertight closure were achieved by the application of fibrin sealant with gelfoam. The mean time for dural closure was 209 s (range 47-420 s). Postoperatively no CSF fistula, no new deficits nor worsening of a pre-existing neurological deficit occu...Continue Reading

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Citations

May 24, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jong Ki ShinJung Sub Lee
Jan 10, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Robert C Mulholland
Apr 17, 2020·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Zeiad A F AlshameeriVinay Jasani
Jan 7, 2021·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Derya Gündoğdu KaraogluAli Dalgic
Jun 16, 2021·Operative Neurosurgery·Gregory W BasilMichael Y Wang
Jan 7, 2022·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Yuqing JiangNanwei Xu

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