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Posterior and postero-lateral incidental durotomy during lumbar spine surgery: primary repair versus augmented primary repair
Faculty
Medicine
Year:
2021
Type of Publication:
ZU Hosted
Pages:
Authors:
Ahmed Mohamed Ihsan Abdallah Elawamry
Staff Zu Site
Abstract In Staff Site
Journal:
Egyptian Journal of Neurosurgery Egyptian Journal of Neurosurgery
Volume:
Keywords :
Posterior , postero-lateral incidental durotomy during lumbar spine
Abstract:
Background: Incidental durotomy (ID) during lumbar spine surgery is a frequent complication of lumbar spine surgical procedures. Many surgical techniques were described in literature for repair of durotomy, however it is a matter of debate if one technique is a gold standard method of repair. Our study described two groups with posterior and postero-lateral ID that occurred during lumbar spine surgery: group A with 34 cases with a mean age of 49.85 years repaired by primary water tight closure using prolene or silk sutures, and group B with 34 cases with a mean age of 47.18 years treated with augmented primary repair (sutures augmented with a graft from lumbar fascia and tissue sealant "Fibrin glue"). Patients were evaluated for risk factors for durotomy, post-operative clinical outcome, and need for revision surgery. Results: Eleven cases of group A and nine cases of group B had previous spine surgery. The dural tear was < 2 cm in 41.7% of group A and 83.3% of group B. Better outcome was achieved in 32 patients of group A and 30 patients of group B. Among our study cases 2 patients from group A and 4 patients from group B needed revision surgery due to CSF leak which failed to stop with conservative management and percutaneous blood patch. Conclusions: Dural closure technique after ID does not seem to infuence revision surgery rates due to cerebrospinal fuid (CSF) leakage and its complications. Durotomies that were immediately recognized and treated did not lead to any signifcant consequences. Keywords: Incidental Durotomy, Revision surgery, Primary repair, Augmented primary repair, CSF leak, Lumbar spine
Author Related Publications
Ahmed Mohamed Ihsan Abdallah Elawamry, "Outcome of microsurgical clipping of anterior circulation aneurysms during the period of vasospasm: single center experience in Egypt", Egyptian Journal of Neurosurgery, 2019
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Ahmed Mohamed Ihsan Abdallah Elawamry, "Role of preoperative computed tomography angiographic anatomical considerations and their intraoperative interpretations in prediction of outcome in microsurgical clipping of ruptured anterior communicating aneurysm", Egyptian Journal of Neurosurgery, 2021
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Ahmed Mohamed Ihsan Abdallah Elawamry, "Relentless pulsatile tinnitus secondary to dural sinovenous stenosis: is endovascular sinus stenting the answer?", Clinical Radiology, 2021
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Ahmed Mohamed Ihsan Abdallah Elawamry, "The Frequency and Risk Factors for Cranial Facet Joint Violation during Pedicle Screw Instrumentation in Lumbar Spine Disorders", Egy Spine J, 2021
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Ahmed Mohamed Ihsan Abdallah Elawamry, "Outcome of surgical treatment of hepatocellular carcinoma-derived spinal metastases: Single center experience in Egypt", Interdisciplinary Neurosurgery, 2022
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Department Related Publications
Safwaat Abohashem Mohamed Abohashim, "Laparoscopic Revision of the Distally Obstructed Ventriculoperitoneal Shunt", Turkish Neurosurgical Society, 2013
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Safwaat Abohashem Mohamed Abohashim, "Endoscopic versus Microscopic Trans-Sphenoidal Approach for Pituitary Adenomas: Retrospective Comparison Study in Single Institution", Egyptian neurosurgical society, 2014
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Safwaat Abohashem Mohamed Abohashim, "Outcome of Laminoforaminotomy for Unilateral Cervical Radiculopathy", MEDC, 2014
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Muntasir Ahmed Abdel Fattah Fouda, "نتائج الازالة الميكرسكوبية لضغط الاوعية الدموية في حالات الشد الوجهى النصفي", لايوجد, 1900
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