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Repair of Inaccessible Ventral Dural Defect in Thoracic Spine: Double Layered Duraplasty
Korean Journal of Spine ; : 87-90, 2016.
Article Dans Anglais | WPRIM | ID: wpr-168432
ABSTRACT
We propose a double layered (intradural and epidural patch) duraplasty that utilizes Lyoplant and Duraseal. We examined a 47-year-old woman after decompression for thoracic ossification of posterior longitudinal ligament was performed in another hospital. On postoperative day 7, she complained of weakness in both legs. Postoperative magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) collection with cord compression. In the operative field, we found 2 large dural defects on the ventral dura mater. We performed a conventional fat graft with fibrin glue. However, the patient exhibited neurologic deterioration, and a postoperative MRI again showed CSF collection. We performed dorsal midline durotomy and inserted a intradural and epidural Lyoplant patch. She immediately experienced diminishing back pain postoperatively. Her visual analog scale and motor power improved markedly. Postoperative MRIs performed at 2 and 16 months showed no spinal cord compression or CSF leakage to the epidural space. We describe a new technique for double layered duraplasty. Although we do not recommend this technique for all dural repairs, double-layered duraplasty may be useful for repairing large inaccessible dural tears in cases of persistent CSF leakage refractory to conventional management.
Sujets)

Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Syndrome de compression médullaire / Rachis / Larmes / Imagerie par résonance magnétique / Colle de fibrine / Liquide cérébrospinal / Dorsalgie / Ossification du ligament longitudinal postérieur / Transplants / Décompression Limites du sujet: Femelle / Humains langue: Anglais Texte intégral: Korean Journal of Spine Année: 2016 Type: Article

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Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Syndrome de compression médullaire / Rachis / Larmes / Imagerie par résonance magnétique / Colle de fibrine / Liquide cérébrospinal / Dorsalgie / Ossification du ligament longitudinal postérieur / Transplants / Décompression Limites du sujet: Femelle / Humains langue: Anglais Texte intégral: Korean Journal of Spine Année: 2016 Type: Article