Complications of Spine Surgery: Evaluation and Treatment of Cervical and Lumbar Dural Tears

Abstract

Incidental dural tears are among the most common complications of spinal surgery, with an incidence of approximately 2% to 3% in primary cases. To a large extent, incidental durotomy may be reduced with careful surgical technique, with appropriate magnification and adequate visualization of the surgical field and epidural space. When a dural tear does occur, it should be suture-repaired, if possible. Watertight closure to prevent leakage is crucial for a positive outcome. If the tear is not amenable to watertight repair, it may be augmented with collagen patching, fibrin glue sealant, and drainage if necessary. Successful repair of a dural tear typically leads to an uneventful recovery; however, left untreated (or with failure of treatment), dural tears can lead to persistent CSF leakage,durocutaneous fistula formation, pseudomeningocele, or, more rarely, meningitis.

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