Perioperative Complications in Lumbar Spine Surgery

Park, Daniel K.; Khurana, Neal; Ellman, Michael B.; Singh, Kern

doi:10.1097/01.css.0000345585.76969.20

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2013

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“…The incidence of unintended intraoperative durotomy is between 0.3% and 17.4% and varies depending on the type of surgical procedure1,4,5,8,10,12-14,16). Because many patients do not show symptoms, the exact incidence of postoperative pseudomeningocele is not known, but the overall incidence is reported to be less than 2%1,5,9,11,15).…”

Section: Discussionmentioning

confidence: 99%

Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases

Choi

Kim

Jang

et al. 2013

J Korean Neurosurg Soc

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Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

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