A Systematic Review on Management of Iatrogenic Dural Tears

Abstract

Incidental durotomy is one of the most common complications during spine surgery. Various studies have reported incidences ranging from 1% to 17% in spine surgeries. Use of high speed drills, decompression for ossification of the posterior longitudinal ligament and spine surgery revision procedures are associated with an increased risk for incidental durotomies. Minimally invasive spine surgery is at least as safe as open techniques with respect to dural tear.Unfortunately not all dural tears can be recognized and repaired adequately primarily. Even with experienced surgeons minimal dural tears may go unrecognized during surgery. If the dural tear is not properly closed or unrecognized; patients can present with postural headaches, vertigo, posterior neck pain, and/or stiffness, nausea, diplopia, photophobia, tinnitus, and blurred vision.The subsequent clinical problems that may arise are diverse and range in severity from clinically insignificant to life-threatening conditions such as meningitis, spinal epidural abscess, and intracranial hemorrhage. However,