Repair of Inaccessible Ventral Dural Defect in Thoracic Spine: Double Layered Duraplasty.
10.14245/kjs.2016.13.2.87
- Author:
Dong Hyun LEE
1
;
Kyoung Tae KIM
;
Jeong Ill PARK
;
Ki Su PARK
;
Dae Chul CHO
;
Joo Kyung SUNG
Author Information
1. Department of Neurosurgery, Spine Center, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, Korea. nskimkt7@gmail.com
- Publication Type:Case Report
- Keywords:
Dura mater;
Repair;
Microtomy;
Cerebrospinal fluid leak
- MeSH:
Back Pain;
Cerebrospinal Fluid;
Cerebrospinal Fluid Leak;
Decompression;
Dura Mater;
Epidural Space;
Female;
Fibrin Tissue Adhesive;
Humans;
Leg;
Magnetic Resonance Imaging;
Microtomy;
Middle Aged;
Ossification of Posterior Longitudinal Ligament;
Spinal Cord Compression;
Spine*;
Tears;
Transplants;
Visual Analog Scale
- From:Korean Journal of Spine
2016;13(2):87-90
- CountryRepublic of Korea
- Language:English
-
Abstract:
We propose a double layered (intradural and epidural patch) duraplasty that utilizes Lyoplant and Duraseal. We examined a 47-year-old woman after decompression for thoracic ossification of posterior longitudinal ligament was performed in another hospital. On postoperative day 7, she complained of weakness in both legs. Postoperative magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) collection with cord compression. In the operative field, we found 2 large dural defects on the ventral dura mater. We performed a conventional fat graft with fibrin glue. However, the patient exhibited neurologic deterioration, and a postoperative MRI again showed CSF collection. We performed dorsal midline durotomy and inserted a intradural and epidural Lyoplant patch. She immediately experienced diminishing back pain postoperatively. Her visual analog scale and motor power improved markedly. Postoperative MRIs performed at 2 and 16 months showed no spinal cord compression or CSF leakage to the epidural space. We describe a new technique for double layered duraplasty. Although we do not recommend this technique for all dural repairs, double-layered duraplasty may be useful for repairing large inaccessible dural tears in cases of persistent CSF leakage refractory to conventional management.
