Anterior dural laceration caused by thoracolumbar and lumbar burst fractures

J Spinal Disord. 2000 Oct;13(5):399-403. doi: 10.1097/00002517-200010000-00005.

Abstract

A retrospective review of the records of 60 patients with thoracolumbar and lumbar burst fractures was undertaken to document the incidence and evaluate the sequelae of dural injuries found during anterior procedures. In the entire series, six (10%) patients each had a preexisting vertically oriented dural tear. All patients with anterior dural lacerations were male and had associated neurologic deficits. In all six patients, preoperative computed tomography showed an asymmetrically retropulsed bone fragment. Dural tears were repaired primarily. A postoperative cerebrospinal fluid leak developed into the chest cavity of one patient, who was treated successfully with subarachnoid drainage. In patients with anterior dural laceration, primary repair is warranted and can be performed more easily after intraoperative correction of kyphosis. Subarachnoid drainage may be effective in cases of continued postoperative anterior cerebrospinal fluid leakage before repeated operation is considered.

MeSH terms

  • Adolescent
  • Adult
  • Cerebrospinal Fluid / physiology
  • Dura Mater / injuries*
  • Dura Mater / pathology*
  • Dura Mater / surgery
  • Humans
  • Internal Fixators / adverse effects
  • Intraoperative Complications / etiology
  • Intraoperative Complications / surgery
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / injuries*
  • Lumbar Vertebrae / surgery
  • Male
  • Pleura / injuries
  • Pleura / pathology
  • Pleura / surgery
  • Radiography
  • Retrospective Studies
  • Spinal Canal / injuries
  • Spinal Canal / pathology
  • Spinal Canal / surgery
  • Spinal Fractures / complications*
  • Spinal Fractures / pathology*
  • Spinal Fractures / surgery
  • Spinal Fusion
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / injuries*
  • Thoracic Vertebrae / surgery