Incidence and Management of Dural Tears in Degenerative Spinal Surgery

Authors

  • LIAQAT ALI Department of Neurosurgery, Saidu Teaching Hospital, Swat
  • MUHAMMAD HUSSAIN Department of Neurosurgery, Saidu Teaching Hospital, Swat
  • NISAR ALI Department of Neurosurgery, Saidu Teaching Hospital, Swat
  • Mohammad Ismail Department of Neurosurgery, Saidu Teaching Hospital, Swat

Keywords:

Dural Tears, Degenerative spinal surgeries, Dural Tears repair

Abstract

Objects: The purpose of this study was to study the incidence, results and treatment of Dural Tears sustained during operation on lumbar spine for degenerative spine diseases in peripheral teaching hospital.
Study Design: This was an observational descriptive study.
Materials and Methods: This study was conducted in the Department of Neuro Surgery Saidu teaching Hospital swat from Jan 2007 to Dec: 2010. During this period a total of 305 patients underwent spinal surgery were included in our study. Preliminary preoperative imaging and preparation was performed in these patients.
Results: A total of 305 patients including in this study. The male female ratio was 1:1.67% out of 305 patients primary surgery was performed in 238 patients while revisional surgery was perform in 67 cases. a total of 29 cases had dural tears, in 27 patients Dural tear was recognized preoperatively out of which 21 tears where repaired and 6 patients were treated conservatively. Conservative treatment was not successful in these 6 patients and they underwent Re exploration and repair. In 2 cases dural tears were diagnosed latter on due to CSF leakage in 1 case pseudomeningocele is 2nd cases conservative trial failed have both were reoperated for dural repair.
Conclusion: Dural tears is more common in revisional surgery and all Dural Tears should be repair.

References

1. Wang JC, Bohlman HH, Riew DK. Dural tears secon-dary to operations on the lumbar spine: management and results after a two – year – minimum follow-up of eighty patients. J Bone joint surg Am 1998; 80: 1728-32.
2. Stolke D, Sollmann W, Seifert V. Intra- and postopera-tive complications in lumbar disc surgery. Spine 1989; 14: 56-9.
3. Cammisa FP Jr, Giradi FP, Sangani PK, et al. Incidental durotomy in spine surgery. Spine 2000; 25: 2663-7.
4. Verner EF, Musher DM. Spinal epidural abscess. Med Clin North Am 1989; 69: 375-84.
5. Saxler G, Kramer J, Barden B, et al. The long-term cli-nical sequelae of incident durotomy in lumbar disc sur-gery. Spine 2055; 30: 2298-302.
6. Eismont, F.J.; Wiesel, S.W.; and Rothman, R.H.; treat-ment of dural tears associated with spinal surgery. J. Bone and Joint Surg., Spet.1981; 63-A: 1132-1136.
7. Jones, A.A,; Stambough, J.L,; Bladerston, R.A,; Roth-man, R.H,; and Booth, R.E., Jr,: Long – term results of lumbar spine surgery complicated by unintended inci-dental durotomy. Spine, 1989; 14: 443-446.
8. Nash, C.L., Jr.; Kaufman, B; and Frankel, V.H Postsur-gical meningeal pseudocysts of the lumbar spine. Clin Orthop., 1971; 75: 167-178.
9. Tafazal Sl, Sell PJ. Incident durotomy in lumbar spine surgery: incidence and management. Eur Spine J 2005; 14: 287-90
10. Bosacco SJ, Gardner MJ, Guille JT. Evaluation and tre-atment of dura tears in lumbar spine surgery. Clin or-thop 2001; 289: 238-47.
11. Jefferey C. Wang, M.D, Nenry H, Rohlman, M.D, K. Daniel, Riew, M.D. Cleveland, Ohio, two years mini-mum follow up of Eighty eight patients, the of journal of Bone and Joint surgery 1998; 80: 1728-32.

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Published

2018-11-04

Issue

Vol. 15 No. 2 (2011): July-December

Section

Original Articles

License

The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).