scholarly journals Risk Factors and Options of Management for an Incidental Dural Tear in Biportal Endoscopic Spine Surgery

2020 ◽  
Vol 14 (6) ◽  
pp. 790-800
Author(s):  
Ju-Eun Kim ◽  
Dae-Jung Choi ◽  
Eugene J. Park
Keyword(s):  
Spinal Surgery ◽  
Contralateral Side ◽  
Dural Tear ◽  
Revision Operation ◽  
Dorsal Midline ◽  
Conversion To Open Surgery ◽  
Endoscopic Spine Surgery ◽  
Clear Visibility ◽  
Patch Technique ◽  
Endoscopic Spinal Surgery

Study Design: Here we perform a retrospective analysis regarding an incidental dural tear (IDT) during biportal endoscopic spinal surgery (BESS).Purpose: This study investigates the causes of IDT specifically related to technical procedures of BESS with the aim of lowering its risk during training.Overview of Literature: The incidence of dural tear is reported 0.5%–18% in open spinal surgery and 1.7%–4.3% during endoscopic spinal surgery. Because conversion to open surgery for direct repair could become necessary during endoscopic spinal surgery, prevention of this complication is essential.Methods: We have retrospectively studied IDTs by four surgeons during 1 or 2 years after starting BESS for lumbar degenerative diseases and analyzed the locations, sizes, and specific endoscopic conditions specific to each.Results: Twenty-five cases (1.6%) of IDTs among 1,551 cases of BESS occurred; 13 cases (52%) of these were within the first 6 months. The locations were dorsal midline in 12 cases, ipsilateral side in 11 cases, and contralateral side in two cases. The tear sizes were <10 mm in 20 cases and ≥10 mm in five cases. IDT commonly occurred due to injury of central dural folding during flavectomy under turbid surgical fields due to small bleeds under water. Twenty cases with IDTs of <10 mm were treated well with the patch technique. Among five cases of ≥10 mm, three underwent open repair within a few days, and two of these which failed to conservative management required a delayed revision operation due to pseudomeningocele. No cases progressed to surgical site infection or infectious spondylitis.Conclusions: IDTs of <10 mm can be successfully treated with the patch technique. To prevent IDT during the early learning period, maintaining clear visibility by securing fluent saline outflow and meticulous hemostasis of small bleeding from exposed cancellous bone and epidural vessels is essential with caution not to injure the central dural folding during midline flavectomy.

Patch technique for repair of a dural tear in microendoscopic spinal surgery

2008 ◽  
Vol 90-B (8) ◽  
pp. 1066-1067 ◽  
Author(s):  
M. Shibayama ◽  
J. Mizutani ◽  
I. Takahashi ◽  
S. Nagao ◽  
H. Ohta ◽  
...  
Keyword(s):  
Spinal Surgery ◽  
Dural Tear ◽  
Patch Technique

scholarly journals P.094 Spinal dural repair: a Canadian questionnaire

2017 ◽  
Vol 44 (S2) ◽  
pp. S37-S37 ◽  
Author(s):  
K Reddy ◽  
S Almenawar ◽  
M Aref ◽  
CT Oitment
Keyword(s):  
Nerve Root ◽  
Spinal Surgery ◽  
Comparative Research ◽  
Research Study ◽  
Response Rate ◽  
Bed Rest ◽  
Optimal Management ◽  
Dural Tear ◽  
Dural Repair ◽  
Dural Tears

Background: Iatrogenic dural tear a complication of spinal surgery with significant morbidity and cost to the healthcare system. The optimal management is unclear, and therefore we aimed to survey current practices among Canadian practitioners. Methods: A questionnaire was administered to members of the Canadian Neurological Surgeon’s Society designed to explore methods of closure of iatrogenic durotomy. Results: Spinal surgeons were surveyed with a 55% response rate (n=91). For pinhole sized tears there is a trend toward sealant fixation(36.7%). Medium and large sized tears are predominantly closed with sutures and sealant(67% and 80%, respectively). Anterior tears are managed using sealant alone(48%). Posterior tears are treated with a combination of sutures and sealant(73.8%). Nerve root tears are treated with either sealant alone(50%). Most respondents recommended bed rest for at least 24 hours in the setting of medium(73.2%) and large(89.1%) dural tears. Conclusions: This study elucidates the areas of uncertainty with regard to iatrogenic dural tear management. There is disagreement regarding management of anterior and nerve root tears, pin-hole sized tears in any location of the spine, and whether patients should be admitted to hospital or on bed-rest following a pin-hole sized dural tear. There is a need for a robust comparative research study of dural repair strategies.

scholarly journals Is biportal technique/endoscopic spinal surgery satisfactory for lumbar spinal stenosis patients?

Medicine ◽  
2019 ◽  
Vol 98 (18) ◽  
pp. e15451 ◽  
Author(s):  
Taewook Kang ◽  
Si Young Park ◽  
Chun Hyung Kang ◽  
Soon Hyuck Lee ◽  
Jong Hoon Park ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Spinal Surgery ◽  
Lumbar Spinal ◽  
Endoscopic Spinal Surgery

Video-assisted endoscopic spinal surgery: Thoracoscopic discectomy

1995 ◽  
Vol 134 (3-4) ◽  
pp. 196-199 ◽  
Author(s):  
A. Caputy ◽  
J. Starr ◽  
C. Riedel
Keyword(s):  
Spinal Surgery ◽  
Video Assisted ◽  
Endoscopic Spinal Surgery

scholarly journals Biportal Endoscopic Spinal Surgery for Recurrent Lumbar Disc Herniations

2016 ◽  
Vol 8 (3) ◽  
pp. 325 ◽  
Author(s):  
Dae-Jung Choi ◽  
Je-Tea Jung ◽  
Sang-Jin Lee ◽  
Young-Sang Kim ◽  
Han-Jin Jang ◽  
...  
Keyword(s):  
Spinal Surgery ◽  
Lumbar Disc ◽  
Disc Herniations ◽  
Endoscopic Spinal Surgery
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