What is a dural tear in spine surgery?
An accidental dural tear is a potential complication of spine surgery. This occurs when the thin covering over the spinal cord (called meninges) is nicked by the surgical instrument.
What is dura surgery?
A dural tear is a major complication in microendoscopic spinal surgery. It requires the surgeon to terminate the procedure and change to open surgery to allow direct suture in order to prevent leakage of cerebrospinal fluid. So far, suture has been the only method of repair.
What are the symptoms of a dural tear?
If a defect goes undetected or is not properly closed, the patient is likely to experience a postural headache with a combination of the following symptoms: nausea, vomiting, pain or tightness in the neck or back, dizziness, diplopia due to VI cranial nerve paresis, photophobia, tinnitus, etc.
How do you repair a dural tear?
Dural tears are repaired using microsurgical techniques – using a microscope and a fine needle. Small dural tears are sutured or stapled close, while larger ones are reconstructed with a patch or graft. Fat or fibrin glue may be used as a sealant to reinforce the repair.
Can the dura repair itself?
Blood does not pass through the spinal cord naturally, and since blood flow is necessary to clot and heal wounds, the dural mater cannot heal on its own.
What is a dural repair?
Is a dural tear a complication?
Takenaka S, Makino T, Sakai Y, et al. Dural tear is associated with an increased rate of other perioperative complications in primary lumbar spine surgery for degenerative diseases. Medicine (Baltimore) 2019; 98:e13970. 10.
Does the dura grow back?
Durepair Dura Regeneration Matrix remodels itself to the patient’s own tissue. The dura mater (literally, “tough mother”) is the dense, leathery membrane covering and protecting the brain and spinal cord.
What causes the dura to tear?
Dural holes or tears can happen due to a number of reasons, whether iatrogenic, traumatic, or spontaneous. Iatrogenic spinal CSF leaks are caused by a medical procedure, intentionally or inadvertently.
How long does it take dura to heal?
The repair site can take four to six weeks to heal completely.
What is a dura Patch?
A dura patch is sewn to expand the space for cerebrospinal fluid to flow around the tonsils. The concept is similar to letting out the waistband on a tight pair of pants. Many patients ask about minimally invasive or endoscopic surgery.
How do you repair the dura?
Dural graft substitutes are used when the opening in the dura is too large to be sutured together. There are many ways the dura can become damaged, including severe head injury, tumor ingrowth (meningioma), or a surgeon’s need to open the dura for access to the brain or spinal cord during invasive surgical procedures.
How do you fix a dural tear?
What can be done for a dural tear?
Dural tears should be repaired at the time of the original operation either directly or utilizing a fascial graft or a tissue-plug technique. When the leak is first noted in the postoperative period, reoperation for repair of the dura is recommended.
How long does it take the dura to heal?