Posterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair

Abstract Background Incidental durotomy (ID) during lumbar spine surgery is a frequent complication of lumbar spine surgical procedures. Many surgical techniques were described in literature for repair of durotomy, however it is a matter of debate if one technique is a gold standard method of repair...

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Autores principales:	Mansour A. Makia, Ahmed Alawamry, Ahmad M. Elsharkawy
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Incidental Durotomy Revision surgery Primary repair Augmented primary repair CSF leak Lumbar spine surgery Surgery RD1-811 Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/edeb9b51660546c6926fafbc88f9da33
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spelling	oai:doaj.org-article:edeb9b51660546c6926fafbc88f9da332021-11-14T12:29:44ZPosterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair10.1186/s41984-021-00123-z2520-8225https://doaj.org/article/edeb9b51660546c6926fafbc88f9da332021-11-01T00:00:00Zhttps://doi.org/10.1186/s41984-021-00123-zhttps://doaj.org/toc/2520-8225Abstract Background Incidental durotomy (ID) during lumbar spine surgery is a frequent complication of lumbar spine surgical procedures. Many surgical techniques were described in literature for repair of durotomy, however it is a matter of debate if one technique is a gold standard method of repair. Our study described two groups with posterior and postero-lateral ID that occurred during lumbar spine surgery: group A with 34 cases with a mean age of 49.85 years repaired by primary water tight closure using prolene or silk sutures, and group B with 34 cases with a mean age of 47.18 years treated with augmented primary repair (sutures augmented with a graft from lumbar fascia and tissue sealant "Fibrin glue"). Patients were evaluated for risk factors for durotomy, post-operative clinical outcome, and need for revision surgery. Results Eleven cases of group A and nine cases of group B had previous spine surgery. The dural tear was < 2 cm in 41.7% of group A and 83.3% of group B. Better outcome was achieved in 32 patients of group A and 30 patients of group B. Among our study cases 2 patients from group A and 4 patients from group B needed revision surgery due to CSF leak which failed to stop with conservative management and percutaneous blood patch. Conclusions Dural closure technique after ID does not seem to influence revision surgery rates due to cerebrospinal fluid (CSF) leakage and its complications. Durotomies that were immediately recognized and treated did not lead to any significant consequences.Mansour A. MakiaAhmed AlawamryAhmad M. ElsharkawySpringerOpenarticleIncidental DurotomyRevision surgeryPrimary repairAugmented primary repairCSF leakLumbar spine surgerySurgeryRD1-811Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENEgyptian Journal of Neurosurgery, Vol 36, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Incidental Durotomy Revision surgery Primary repair Augmented primary repair CSF leak Lumbar spine surgery Surgery RD1-811 Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	Incidental Durotomy Revision surgery Primary repair Augmented primary repair CSF leak Lumbar spine surgery Surgery RD1-811 Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Mansour A. Makia Ahmed Alawamry Ahmad M. Elsharkawy Posterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair
description	Abstract Background Incidental durotomy (ID) during lumbar spine surgery is a frequent complication of lumbar spine surgical procedures. Many surgical techniques were described in literature for repair of durotomy, however it is a matter of debate if one technique is a gold standard method of repair. Our study described two groups with posterior and postero-lateral ID that occurred during lumbar spine surgery: group A with 34 cases with a mean age of 49.85 years repaired by primary water tight closure using prolene or silk sutures, and group B with 34 cases with a mean age of 47.18 years treated with augmented primary repair (sutures augmented with a graft from lumbar fascia and tissue sealant "Fibrin glue"). Patients were evaluated for risk factors for durotomy, post-operative clinical outcome, and need for revision surgery. Results Eleven cases of group A and nine cases of group B had previous spine surgery. The dural tear was < 2 cm in 41.7% of group A and 83.3% of group B. Better outcome was achieved in 32 patients of group A and 30 patients of group B. Among our study cases 2 patients from group A and 4 patients from group B needed revision surgery due to CSF leak which failed to stop with conservative management and percutaneous blood patch. Conclusions Dural closure technique after ID does not seem to influence revision surgery rates due to cerebrospinal fluid (CSF) leakage and its complications. Durotomies that were immediately recognized and treated did not lead to any significant consequences.
format	article
author	Mansour A. Makia Ahmed Alawamry Ahmad M. Elsharkawy
author_facet	Mansour A. Makia Ahmed Alawamry Ahmad M. Elsharkawy
author_sort	Mansour A. Makia
title	Posterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair
title_short	Posterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair
title_full	Posterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair
title_fullStr	Posterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair
title_full_unstemmed	Posterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair
title_sort	posterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/edeb9b51660546c6926fafbc88f9da33
work_keys_str_mv	AT mansouramakia posteriorandposterolateralincidentaldurotomyduringlumbarspinesurgeryprimaryrepairversusaugmentedprimaryrepair AT ahmedalawamry posteriorandposterolateralincidentaldurotomyduringlumbarspinesurgeryprimaryrepairversusaugmentedprimaryrepair AT ahmadmelsharkawy posteriorandposterolateralincidentaldurotomyduringlumbarspinesurgeryprimaryrepairversusaugmentedprimaryrepair
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Posterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair

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