INCIDENTAL DURAL TEAR IN LUMBAR DECOMPRESSION SURGERY: INCIDENCE, POSITIONS, MANAGEMENT PROTOCOL AND RESULTS

Abstract

Objective: The aim of this study was to define incidence, position of dural tear in lumbar decompression interventions and evaluate the outcome of the management protocol. Methods: The records of consecutive patients with different types of posterior decompress-sive and reconstructive procedures in the lumbar region are investigated retrospectively for the period 2014 – 2018. Incidence of this complication regarding kinds of indications and surgical techniques, and common areas of breaches were analyzed. All the patients were applied our protocol to deal with this problem. We also analyzed the possibility of suturing, clinical symptoms (headache), and delayed complications (dural fistula or meningoceles). Results: The 1024 procedures included 62 dural tear complications (6.05%). The most common position of breachs were posterior and lateroposterior aspects (82.21%). There were no late complications detected: no symptomatic fistula or meningocele. There was one of the patients had a second surgery. Conclusions: Dural tear is a severe complication and badly affect to outcome. Thus, it is important to be careful in decompression surgery. If resolving this problem approximately can provide satisfactory results for patients Key words: Lumbar decompression surgery, dural tear, CSF leak