What is a Durotomy?
Incidental durotomy refers to unintended tears or puncture of the dura mater: the tough outer membrane covering the spinal cord. Dural tears occur frequently during spinal surgery; when promptly recognized and repaired, they generally cause no long-term problems.
What is intraoperative Durotomy?
Abstract. Incidental durotomy (ID) is a common intraoperative complication of spine surgery. It can lead to persistent cerebrospinal fluid leakage, which may cause serious complications, including severe headache, pseudomeningocele formation, nerve root entrapment, and intracranial hemorrhage.
What is dura in your back?
The dura is a thin layer of tissue that covers and protects the spinal cord. It lies in between the spine (the bone) and the spinal cord (nerve tissue). Durotomy, which is an incision in the dura, can be a planned part of the surgical technique.
What is a dural repair?
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.
What is Flavum?
The ligamentum flavum, or the yellow ligament, is a thick, segmental ligament that runs between the lamina of adjacent vertebrae (Fig. 1-11). It begins on the undersurface of the inferior border of the lamina and courses down to the leading superior edge of the lamina (Fig. 1-12).
How serious is a dura tear?
Cerebrospinal fluid (CSF) leakage following dural tears can pose potentially serious problems such as CSF fistula formation, pseudomeningocele, meningitis, arachnoiditis and epidural abscess[1,3,10,12,15].
Is a dural tear painful?
The general part of the dural leak symptoms are the symptoms themselves like a headache. Meaning there are dozens of medical problems that can also cause headaches. Hence, sorting through all of those may be needed to make sure the patient has a dural leak causing their headache.
What causes the dura to tear?
Dural tears may occur inadvertently at the time of epidural injections (epidural refers to the space in the spinal canal outside of dura and spinal cord). They may also occur at the time of surgery. Traumatic spinal CSF leaks are caused as a result of an injury.
What is a dural patch made of?
ReDura is regenerative dural repair patch made of synthetic absorbable biomaterial scaffold resembling microstructure of native dural matrix that provides appropriate environment for recruitment, growth, and proliferation of dural cell on scaffolds.
What is Flavum thickening?
Ligamentum flavum hypertrophy is a condition in which the ligamentum flavum (LF) thickens due to stresses placed on the spine. With hypertrophy, ligamentum flavum (LF) increases in thickness (size). The thicker it becomes, the higher the risks of compressing the spinal cord or spinal nerves.
What is S P laminectomy?
Laminectomy is surgery that creates space by removing the lamina — the back part of a vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves.
Does lumbar laminectomy weaken the spine?
A few potential complications of open lumbar laminectomy are: Neural tissue damage. Injury to the spinal cord’s dura, cauda equina syndrome, nerve roots, and the formation of scar tissue may occur causing neural tissue damage in the lumbar spine.
Is lumbar laminectomy a major surgery?
One concern you might develop is: Is a laminectomy a major surgery? The truth is, this surgery option is minimally invasive and, at most, might require a short hospital stay. Laminectomy offers you relief from the pain and neurological conditions that result from spinal stenosis.
How do you treat 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.
Is a dural tear serious?
What is a durotomy?
Durotomy. meaning. (medicine) Incursion of the dura, especially during spinal surgery.
What is an incidental durotomy?
What is an incidental durotomy? A good example that comes to mind is a spine surgery complication called incidental durotomy. During a spine surgery, it’s a known risk that the surgeon may accidentally puncture the protective outer layer of the spinal cord or nerve roots called the dura mater. When this happens, it’s called an incidental durotomy.
What is the incidence of durotomy in surgery?
The reported incidence varies from as low as 1% to as high as 17% in series ranging from 5 to 450 patients. In one study looking into medicolegal aspects of spine surgery [4], 146 malpractice cases were reviewed and incidental durotomy was the second most frequent complication in such cases.