Dural Tears Secondary to Operations of the Lumbar Spinal Disorders / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: A retrospective study. PURPOSE: To review the results of the treatment of dural tears, sustained during operations on the lumbar spinal disorders. MATERIALS AND METHODS: From Jan. 1991 to Dec. 2000, 694 consecutive patients had a decompression of the lumbar spine, 35(5%) patients sustained a dural tear during the operations. Of 32 patients who were followed up for more than one year, 29 patients were detected dural tear intraoperatively. 24 patients were treated with primary repair, 4 patients with fibrin glue and one patient with dural reconstruction and fibrin glue. Postoperative management consisted of closed wound drainage for an average of 3.3 days and bed rest for an average of 9.3 days. RESULTS: The total subfascial drains averaged an output of 626(18-1698) milliliters of 32 patients. Clinical symptoms were complained of headache in 12 patients, nausea in 7 patients, dizziness and vomiting in 2 patients postoperatively, but all had resolution of these symptoms after conservative treatment. A superficial wound infection occurred in one of these patients, managed with antibiotic therapy. Whereas the deep wound infection occurred in one, managed with wound debridement and antibiotic therapy successfully. A mean follow up of 34 months was available and showed satisfactory clinical results for 29 of the patients(91%). CONCLUSION: Closed wound drainage can be used safely in the presence of a dural repair and the patient needs to keep on bed rest while the drainage into a sterile bag is performed.