el husseini, mohamed dar al amal hospital - department of neurosurgery, Baalbeck, Lebanon , el affi, mehde dar al amal hospital - department of neurosurgery, Baalbeck, Lebanon , haidar, khalil hôpital libano-français - department of general surgery, Zahle, Lebanon

INCIDENTAL DURAL FISSURES DURING DEGENERATIVE SPINE SURGERY

34051

Dural sac tear is an infrequent, but well recognized complication of spine surgery in which the thin layer over the spinal cord is cut by the neurosurgeon during lumbar spine operations for degenerative disorders. Its incidence varies depending on several risk factors and regarding the intra- and postoperative management. This study included 134 patients who were operated for recurrences over two years interval. Intraoperative dural fissures were repaired through suture, by applying muscle and fat grafts. One case presented a cerebrospinal fluid (CSF) fistula which was repaired at reintervention. Dural tears occurred in 10 cases representing 67.7% of all cases. Risk factors include older age, female sex, obesity, surgeon’s experience, previous operation at the same level. All incidental dural fissures during operations for degenerative lumbar disorders must be diagnosed and immediately repaired to prevent complications such as CSF fistula, osteodiscitis and increased costs of the treatment. Dural sac tears can be prevented, identified and treated, respecting a precise surgical technique and a standardized treatment protocol. Unintended durotomies were associated with fewer complications than previously reported in open spinal operations.

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dural sac tear , dural fissure , CSF fistula

Lebanese Medical Journal

231