Hershman S, Cuellar VG et al (2013) Delayed presentation of incidental durotomy. Kundu A, Sano Y et al (2008) Case report: delayed presentation of postural headache in an adolescent girl after microscopic lumbar discectomy. AJR 140(6):1203–1206Ĭammisa FP Jr, Girardi FP et al (2000) Incidental durotomy in spine surgery. Teplick JG, Peyster RG et al (1983) CT Identification of postlaminectomy pseudomeningocele. Mayfield FH (1976) Complications of laminectomy. Swanson HS, Fincher EF (1947) Extradural arachnoidal cysts of traumatic origin. Hawk MW, Kim KD (2000) Review of spinal pseudomeningoceles and cerebrospinal fluid fistulas. Management and results after a two-year-minimum follow-up of eighty-eight patients. Wang JC, Bohlman HH et al (1998) Dural tears secondary to operations on the lumbar spine. Stromqvist F, Jonsson B et al (2012) Dural lesions in decompression for lumbar spinal stenosis: incidence, risk factors and effect on outcome. Jones AA, Stambough JL et al (1989) Long-term results of lumbar spine surgery complicated by unintended incidental durotomy. A high suspicion and vigilance can help discover and address delayed CSF leaks with no long-term sequelae.Įismont FJ, Wiesel SW et al (1981) Treatment of dural tears associated with spinal surgery. ConclusionĪ delayed symptomatic presentation of DT unrecognised intraoperatively is a specific complication that needs to be recognised and treated appropriately. At 9 months mean follow-up, there was no significant difference in outcome in cases with LPDT compared to those without. Out of the 15 patients who underwent surgery, two patients required another operation and 2 patients were treated with a subarachnoid drain. Fifteen patients required surgical intervention, one patient was treated with insertion of a subarachnoid drain and only one patient settled with conservative measures. Seventeen patients (0.83 %) were found to have LPDT, unrecognised intraoperatively. ResultsĪ total of 2052 patient records were reviewed. MethodsĪ retrospective review was conducted on 2052 consecutive patients who underwent spinal surgery by two spinal surgeons from 2000 to 20 to 2013 at two institutions. The aim of this study is to determine the incidence of late presentation of dural tear (LPDT) following lumbar spinal surgery, its treatment, associated complications and clinical outcomes from long-term follow-up in a consecutive series of patients. To our knowledge, there are no long-term studies describing specifically the incidence and management of this complication. Apart from few reports describing delayed symptomatic CSF leaks, most studies tend not to separate intraoperatively recognised DTs from delayed symptomatic CSF leaks. Most cases of DT are recognised and addressed intraoperatively however, a small percentage of cases may present at a later stage with delayed symptoms of CSF leak, either due to an unrecognised intraoperative DT or as a result of a de novo delayed DT. Dural tear (DT) resulting in cerebrospinal fluid (CSF) leak is a common complication of spinal surgery.
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