UNINTENDED DURAL INJURY IN DEGENERATIVE LUMBAR SPINAL SURGERY: A RETROSPECTIVE STUDY

Özet

Objective: Unintended dural injury rate in all spinal surgeries is between 0.2% and 20%. This rate approaches the upper rates in degenerative lumbar surgery. Unintended dural injury occurs due to many factors and revision surgery is one of these reasons. As a result of the injury, the possibility of neurological deficits is not high, but conditions such as headache, pesudomeningocele, superficial infection, meningitis and radicular pain can occur. However, these complications can be solved today. In our study, we aimed to evaluate unintended dural injury and its results retrospectively. Materials and Methods: Between 2011 and 2018, 376 (225 female and 151 male) patients who had undergone decompression and posterior lumbar pedicle screw fixation were included in the study. Fifty-eight patients were operated due to revision surgery. The mean patient age was 57.35 years (range: 33-79 years). Dural injuries were sutured with microsurgical technique and sealant was used. All patients were recommended bed rest between 24 and 48 hours. Results: The number of unintended dural injuries was 26. Eleven patients with dural injury were operated for revision surgery. There was pseudomeningocele in three patients, superficial wound infection in three patients, meningitis in one patient, and transient radicular symptoms in 12 patients. Twenty-one patients had early cerebral hypotension and all responded to the medication. Conclusion: Unintended dural injury occurring in surgeries performed due to lumbar degenerative process does not significantly affect surgical results. It is very important to properly diagnose and treat additional complications caused by unintended dural injury.