Analysis and administration of small dural tears in major lumbar spinal decompression and discectomy surgical procedure.
J Clin Neurosci. 2018 Feb 08;:
Authors: Galarza M, Gazzeri R, Alfaro R, de la Rosa P, Arraez C, Piqueras C
Incidental dural tear is likely one of the commonest intraoperative problems in lumbar backbone surgical procedure. But, its technical administration for the prevention of CSF leak is controversial. The strategy of managing dural tears will depend on the placement of the dural tears as properly on the size and anatomical traits of the dural tear. We suggest an anatomical classification for small (lower than one cm) dural tears and report on the end result of managing these dural tears varieties utilizing totally different approach for various kind. 62 sufferers underwent spinal dural restore after microdiscectomy or lumbar spinal decompression. Group 1 consisted of 20 sufferers, with Sort I or gentle dural tear who had tissue-glue coated collagen sponge or fibrin glue software. Group 2 comprised 21 sufferers with Sort II or reasonable dural tear who had each tissue-glue coated collagen sponge and fibrin glue software. Group three comprised 21 sufferers with Sort III or extreme dural tear who had polypropylene suture and tissue-glue coated collagen sponge and/or fibrin glue software. Evident postoperative CSF leak was used to find out the affected person’s postoperative consequence. Postoperative CSF leak was not evident throughout a minimal 1?yr comply with up in group 1. Inner CSF leak was evident in group 2 (n?=?three) and group three (n?=?three) throughout identical comply with up. Three sufferers underwent re-do spinal surgical procedure for CSF leak restore. We suggest totally different administration approach relying on the kind of tear. For kind I, we suggest the usage of tissue-glue coated collagen sponge or fibrin glue software, with out dural suturing.
PMID: 29429786 [PubMed – as supplied by publisher]