Abstract
Background: One of the most frequent complications of spinal surgery is accidental dural tears (ADTs). Minimal access surgical techniques (MAST) have been described as a promising approach to minimizing such complications. ADTs have been studied extensively in connection with open spinal surgery, but there is less literature on minimally invasive spinal surgery (MISS).Materials and Methods: We reviewed 187 patients who had undergone degenerative lumbar spinal surgery using minimally invasive spinal fusions techniques. We analyzed the influence of age, Body Mass Index (BMI), smoking, diabetes, and previous surgery on the rate of ADTs in MISS.Results: Twenty-two patients (11.764%) suffered from an ADT. We recommended bed rest for two and a half to 5 days, depending on the type of repair required and the amount of cerebrospinal fluid (CSF) leakage. We could not find any statistically significant correlation between ADTs and age (p = 0.34,), BMI (p = 0.92), smoking (p = 0.46), and diabetes (p = 0.71). ADTs were significantly more frequent in cases of previous surgery (p < 0.001). None of the patients developed a transcutaneous CSF leak or post-operative infection.Conclusions: The frequency of ADTs in MISS appears comparable to that encountered when using open surgical techniques. Additionally, MAST produces less dead space along the corridor to the spine. Such reduced dead space may not be enough for pseudomeningocele to occur, cerebrospinal fluid to accumulate, and fistula to form. MAST, therefore, provides a certain amount of protection.
Highlights
Invasive access surgery techniques (MAST) are associated with reduced blood loss, faster recovery, and reduced perioperative morbidity while yielding similar results to open procedures [1,2,3,4]
Three patients of the accidental dural tears (ADTs) group were in the normal weight BMI group, nine patients in the overweight group, and 10 patients in the obese group, and the standard three-sample test for equality of proportions yielded a p-value of 0.92, and no significant difference between the weight groups
According to our results and those published in the literature, the essential advantages of Minimally invasive spinal surgery (MISS) techniques range from minimized soft tissue damage, reduced blood loss, diminished post-operative pain to a shorter length of stay in hospital [1, 2, 4, 32, 33]
Summary
Invasive access surgery techniques (MAST) are associated with reduced blood loss, faster recovery, and reduced perioperative morbidity while yielding similar results to open procedures [1,2,3,4]. For minimally invasive lumbar spine surgery, Dural Tears in Minimally-Invasive Spine Surgery endoscopic techniques [5] and techniques using tubular retractor systems were introduced. Intraoperative complications, especially ADTs, have scarcely been reported in connection with minimally invasive spinal procedures. The frequency of ADTs in MISS is reported to range from 3.2 to 16.7% [7,8,9,10,11] This prospective study aimed to examine whether patients who undergo minimally invasive surgery (MIS) of the spine are at a higher risk of experiencing an ADT. ADTs have been studied extensively in connection with open spinal surgery, but there is less literature on minimally invasive spinal surgery (MISS)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
