Preventing Dural Tears During Spine Surgery
Category: Spine Surgery | Author: Stefano Sinicropi
During every surgical operation, spine surgeons and their medical team work tirelessly to ensure they do everything in their power to prevent against possible operative complications. We’ve talked about a number of different potential complications on the blog in the past, but one risk we haven’t touched on all that much is the prospect of a dural tear.
A dural tear involves a tear to the dura mater, which is a watertight sac of tissue that covers and protects the spinal cord and spinal nerves. Tears to this tissue can cause cerebrospinal fluid leaks and increase your risk of other health issues.
Causes and Symptoms of Spinal Dural Tears
Dural tears can occur due to acute injury if disc material rubs or tears the dural mater. However, they are much more common during surgery, especially if it’s not the first time this area of your spine is being operated on. When these tears are recognized during surgery, they can be patched quite easily by the spine surgeon. Problems occur when dural tears go unnoticed, and cerebrospinal fluid begins to leak from the tear site.
Complications due to unaddressed dural tears include:
- Cerebrospinal fluid leak
- Spinal headaches
- Infections such as spinal meningitis
Preventing and Treating Dural Tears
Surgeons work with precision to prevent dural tears, but sometimes the dural mater actually needs to be punctured in order for surgeons to access the surgical site or administer a spinal tap. In these situations, surgeons can either repair the tear with sutures or provide an epidural blood patch, which will allow the site to seal and heal itself.
It’s not always easy for the surgeon to repair a dural tear, because there are a number of spinal nerves close by. Should one or more spinal nerves get caught in the suture process, it can result in mild or moderate discomfort and pain, and a second operation may be necessary.
After the tear is corrected, especially if the seal is not water tight, the patient is advised to remain lying down for at least 24 hours. This will keep the cerebrospinal fluid from moving and leaking, and it will give the body enough time to create a sufficient seal on its own.
