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DOI: 10.1055/s-0032-1320028
The Frequency of Accidental Dural Tears in Minimally Invasive Spinal Fusion Techniques
Publikationsverlauf
08. September 2010
27. März 2012
Publikationsdatum:
18. Dezember 2012 (online)
Abstract
Background Accidental dural tears (ADTs) are one of the most frequent complications of spinal surgery. Minimally invasive spinal surgery (MISS) has been described as a promising approach in the literature. ADT has been extensively reported in connection with open spinal surgery, but less so in the context of MISS.
Patients and Methods We reviewed 72 patients who had undergone minimally invasive spinal fusions techniques.
Results Ten patients (13.9%) had an ADT. We recommended bed rest for 2.5 to 5 days, depending on the type of repair and the size of cerebrospinal fluid leakage. One patient suffered from a transient meningism, whereas the others remained free of symptoms associated with ADT.
Conclusion Despite the rather small series investigated in the study, the frequency of ADT in MISS appears to be comparable to that encountered when using open surgical techniques.
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References
- 1 Ntoukas V, Müller A. Minimally invasive approach versus traditional open approach for one level posterior lumbar interbody fusion. Minim Invasive Neurosurg 2010; 53 (1) 21-24
- 2 Park Y, Ha JW. Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. Spine (Phila Pa 1976) 2007; 32 (5) 537-543
- 3 Scheufler KM, Dohmen H, Vougioukas VI. Percutaneous transforaminal lumbar interbody fusion for the treatment of degenerative lumbar instability. Neurosurgery 2007; 60 (4) (Suppl. 02) 203-212 ; discussion 212–203
- 4 Foley KT, Holly LT, Schwender JD. Minimally invasive lumbar fusion. Spine (Phila Pa 1976) 2003; 28 (15 Suppl) S26-S35
- 5 Selznick LA, Shamji MF, Isaacs RE. Minimally invasive interbody fusion for revision lumbar surgery: technical feasibility and safety. J Spinal Disord Tech 2009; 22 (3) 207-213
- 6 Than KD, Wang AC, Etame AB, La Marca F, Park P. Postoperative management of incidental durotomy in minimally invasive lumbar spinal surgery. Minim Invasive Neurosurg 2008; 51 (5) 263-266
- 7 Epstein NE. The frequency and etiology of intraoperative dural tears in 110 predominantly geriatric patients undergoing multilevel laminectomy with noninstrumented fusions. J Spinal Disord Tech 2007; 20 (5) 380-386
- 8 Telfeian AE, Reiter GT, Durham SR, Marcotte P. Spine surgery in morbidly obese patients. J Neurosurg 2002; 97 (1, Suppl) 20-24
- 9 Wang JC, Bohlman HH, Riew KD. Dural tears secondary to operations on the lumbar spine. Management and results after a two-year-minimum follow-up of eighty-eight patients. J Bone Joint Surg Am 1998; 80 (12) 1728-1732
- 10 Foley KT, Smith MM. Microendoscopic discectomy. Tech Neurosurg 1997; 3: 301-307
- 11 Holly LT, Schwender JD, Rouben DP, Foley KT. Minimally invasive transforaminal lumbar interbody fusion: indications, technique, and complications. Neurosurg Focus 2006; 20 (3) E6
- 12 Park P, Upadhyaya C, Garton HJ, Foley KT. The impact of minimally invasive spine surgery on perioperative complications in overweight or obese patients. Neurosurgery 2008; 62 (3) 693-699 , discussion 693–699
- 13 Tafazal SI, Sell PJ. Incidental durotomy in lumbar spine surgery: incidence and management. Eur Spine J 2005; 14 (3) 287-290
- 14 Khan MH, Rihn J, Steele G , et al. Postoperative management protocol for incidental dural tears during degenerative lumbar spine surgery: a review of 3,183 consecutive degenerative lumbar cases. Spine (Phila Pa 1976) 2006; 31 (22) 2609-2613
- 15 Yayama T, Baba H, Furusawa N , et al. Pathogenesis of calcium crystal deposition in the ligamentum flavum correlates with lumbar spinal canal stenosis. Clin Exp Rheumatol 2005; 23 (5) 637-643
- 16 Harms J, Rolinger H. [A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author's transl)]. Z Orthop Ihre Grenzgeb 1982; 120 (3) 343-347
- 17 Eismont FJ, Wiesel SW, Rothman RH. Treatment of dural tears associated with spinal surgery. J Bone Joint Surg Am 1981; 63 (7) 1132-1136
- 18 Hodges SD, Humphreys SC, Eck JC , et al. Management of incidental durotomy without mandatory bed rest. A retrospective review of 20 cases. Spine (Phila Pa 1976) 1999; 24 (19) 2062-2064
- 19 Cole IV JS, Jackson TR. Minimally invasive lumbar discectomy in obese patients. Neurosurgery 2007; 61 (3) 539-544 , discussion 544
- 20 Stevens KJ, Spenciner DB, Griffiths KL , et al. Comparison of minimally invasive and conventional open posterolateral lumbar fusion using magnetic resonance imaging and retraction pressure studies. J Spinal Disord Tech 2006; 19 (2) 77-86
- 21 Kim KT, Lee SH, Suk KS, Bae SE. The quantitative analysis of tissue injury markers after mini-open lumbar fusion. Spine (Phila Pa 1976) 2006; 31 (6) 712-716