Postoperative mangement of incidental durotomy in minimally invasive lumbar spinal surgery

Khoi Than, A. C. Wang, A. B. Etame, F. La Marca, P. Park

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Unintended durotomy is a relatively common complication in spine surgery, with a reported incidence up to 14%. Traditional management has been mandatory bed rest for at least 48 h following repair, with or without placement of a drain. With the muscle-splitting approach and decreased potential (dead) space created during minimally invasive spinal surgery (MISS), there is less potential likelihood of symptoms such as spinal headaches or cerebrospinal fluid fistulas. We reviewed the cases of 5 patients undergoing lumbar MISS complicated by an incidental dural tear. Surgical treatment consisted of primary repair and/or use of DuraGen followed by application of either DuraSeal or Tisseel. Although the duration of bed rest varied, postoperative management involved early mobilization less than 48 h after surgery without the use of a drain. One patient was mobilized early on the second postoperative day, 2 patients were mobilized the morning after surgery, and 2 patients were mobilized immediately upon recovery from anesthesia. None of the patients developed symptoms related to durotomy. Although this represents a small series, early postoperative mobilization appears to be a reasonable option and results in shorter hospitalization.

Original languageEnglish (US)
Pages (from-to)263-266
Number of pages4
JournalMinimally Invasive Neurosurgery
Volume51
Issue number5
DOIs
StatePublished - Oct 2008
Externally publishedYes

Fingerprint

Early Ambulation
Bed Rest
Minimally Invasive Surgical Procedures
Fibrin Tissue Adhesive
Tears
Fistula
Headache
Cerebrospinal Fluid
Hospitalization
Spine
Anesthesia
Muscles
Incidence
Therapeutics

Keywords

  • Cerebrospinal fluid leak
  • Dural tear
  • Minimally invasive technique
  • Spinal surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Postoperative mangement of incidental durotomy in minimally invasive lumbar spinal surgery. / Than, Khoi; Wang, A. C.; Etame, A. B.; La Marca, F.; Park, P.

In: Minimally Invasive Neurosurgery, Vol. 51, No. 5, 10.2008, p. 263-266.

Research output: Contribution to journalArticle

Than, Khoi ; Wang, A. C. ; Etame, A. B. ; La Marca, F. ; Park, P. / Postoperative mangement of incidental durotomy in minimally invasive lumbar spinal surgery. In: Minimally Invasive Neurosurgery. 2008 ; Vol. 51, No. 5. pp. 263-266.
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