Thecal repair in post-surgical pseudomeningocoele

Kaar, George; Briggs, Michael; Bashir, Saad H.

doi:10.3109/02688699409101184

Cited by 10 publications

(9 citation statements)

References 7 publications

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“…5,17,19,20,49,63 Although lumbar drains and bed rest may be useful as nonoperative approaches to treat these conditions, surgery is often required. 5,17,19,20,49,63 Although lumbar drains and bed rest may be useful as nonoperative approaches to treat these conditions, surgery is often required.…”

Section: Discussionmentioning

confidence: 99%

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Collagen Matrix (DuraGen) in Dural Repair: Analysis of a New Modified Technique

Narotam

Jose

Nathoo

et al. 2004

Spine

188

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Section: Discussionmentioning

confidence: 99%

“…5,17,19,20,49,63 Although lumbar drains and bed rest may be useful as nonoperative approaches to treat these conditions, surgery is often required. 20 This method may be useful if initial surgery with collagen matrix and lumbar drainage fails. There was 1 failure, requiring lumbar drainage.…”

Section: Discussionmentioning

confidence: 99%

Collagen Matrix (DuraGen) in Dural Repair: Analysis of a New Modified Technique

Narotam

Jose

Nathoo

et al. 2004

Spine

188

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“…43 However, neurological deficit does not always occur, as Wang et al noted no instances of neural damage resulting from unintended durotomy during lumbar spinal surgery in a large retrospective study of 641 patients. 43 Several comorbidities have been reported to occur after an unintended durotomy including spinal headaches, 34 pseudomeningocoele, 18 meningitis, 24 and nerve root entrapment resulting in intractable pain.…”

mentioning

confidence: 99%

Unintended durotomy in lumbar degenerative spinal surgery: a 10-year systematic review of the literature

Ghobrial

Theofanis

Darden

et al. 2015

FOC

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OBJECT Unintended durotomy is a common occurrence during lumbar spinal surgery, particularly in surgery for degenerative spinal conditions, with the reported incidence rate ranging from 0.3% to 35%. The authors performed a systematic literature review on unintended lumbar spine durotomy, specifically aiming to identify the incidence of durotomy during spinal surgery for lumbar degenerative conditions. In addition, the authors analyzed the incidence of durotomy when minimally invasive surgical approaches were used as compared with that following a traditional midline open approach. METHODS A MEDLINE search using the term “lumbar durotomy” (under the 2015 medical subject heading [MeSH] “cerebrospinal fluid leak”) was conducted on May 13, 2015, for English-language medical literature published in the period from January 1, 2005, to May 13, 2015. The resulting papers were categorized into 3 groups: 1) those that evaluated unintended durotomy rates during open-approach lumbar spinal surgery, 2) those that evaluated unintended durotomy rates during minimally invasive spine surgery (MISS), and 3) those that evaluated durotomy rates in comparable cohorts undergoing MISS versus open-approach lumbar procedures for similar lumbar pathology. RESULTS The MEDLINE search yielded 116 results. A review of titles produced 22 potentially relevant studies that described open surgical procedures. After a thorough review of individual papers, 19 studies (comprising 15,965 patients) pertaining to durotomy rates during open-approach lumbar surgery were included for analysis. Using the Oxford Centre for Evidence-Based Medicine (CEBM) ranking criteria, there were 7 Level 3 prospective studies and 12 Level 4 retrospective studies. In addition, the authors also included 6 studies (with a total of 1334 patients) that detailed rates of durotomy during minimally invasive surgery for lumbar degenerative disease. In the MISS analysis, there were 2 prospective and 4 retrospective studies. Finally, the authors included 5 studies (with a total of 1364 patients) that directly compared durotomy rates during open-approach versus minimally invasive procedures. Studies of open-approach surgery for lumbar degenerative disease reported a total of 1031 durotomies across all procedures, for an overall durotomy rate of 8.11% (range 2%–20%). Prospectively designed studies reported a higher rate of durotomy than retrospective studies (9.57% vs 4.32%, p = 0.05). Selected MISS studies reported a total of 93 durotomies for a combined durotomy rate of 6.78%. In studies of matched cohorts comparing open-approach surgery with MISS, the durotomy rates were 7.20% (34 durotomies) and 7.02% (68), respectively, which were not significantly different. CONCLUSIONS Spinal surgery for lumbar degenerative disease carries a significant rate of unintended durotomy, regardless of the surgical approach selected by the surgeon. Interpretation of unintended durotomy rates for lumbar surgery is limited by a lack of prospective and cohort-matched controlled studies.

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“…Arachnoid membrane inflammation (arachnoidit) may result in persistent irritation of the nerve roots if persists [52] . Early identification and treatment of these complications are very important to prevent from permanent neurological deficits [61] . Postsurgical pseudomeningocele is an uncommon complication of spinal surgery [62] .…”

Section: Postoperative Factorsmentioning

confidence: 99%

“…Postsurgical pseudomeningocele is an uncommon complication of spinal surgery [62] . The reasons of the pseudomeningocele include dural rupture or insufficient closure during surgery [61,63] . Persistent…”

Section: Postoperative Factorsmentioning

confidence: 99%

Failed Back Surgery: A Clinical Review

Şahin

Sargın

Atik

2015

International Journal of Orthopaedics

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Failed back surgery syndrome (FBSS, failed back syndrome) is a chronic disorder that has many impacts on the patients and health care systems. The predisposing factors may occur in the preoperative, intraoperative, and postoperative periods. The term FBSS is often misused. It is not actually a syndrome, but is a very generalized term that is often used to describe the condition of patients who had unsuccessful results with back surgery or spine surgery, or experienced continued pain after surgery. Patients describe uncontrolled persistent back, back/leg or leg pain with functional insufficiency with or without sciatica after 10-40% of the all spinal surgeries. Literature about the FBSS is insufficient, due to the complexity of this entity with variety of the underlying etiology and lack of high-quality clinical trials determining response to treatment modalities. This review aims to summarize current concepts in the ligthnings of literature findings.

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Thecal repair in post-surgical pseudomeningocoele

Cited by 10 publications

References 7 publications

Collagen Matrix (DuraGen) in Dural Repair: Analysis of a New Modified Technique

Collagen Matrix (DuraGen) in Dural Repair: Analysis of a New Modified Technique

Unintended durotomy in lumbar degenerative spinal surgery: a 10-year systematic review of the literature

Failed Back Surgery: A Clinical Review

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