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Dural Repair or Other Spinal Cord Repair

The spinal cord is covered by three layers of tissue called meninges, the outermost being the dura mater. Although it is a rare complication, the dura may get injured or tear during spinal surgery resulting in the leakage of cerebrospinal fluid (CSF), which normally surrounds the brain and spinal cord. This can cause severe headaches and nausea. Spinal cord injury can occur as a result of trauma, or from arthritis, bleeding, cancer, infection and inflammation. The effects of a spinal cord injury can range from transient deficits to more serious complications such as paralysis or bladder and bowel dysfunction.

During spine surgery, injury may occur due to instruments used to decompress nerves, misplaced implants or grafts, manipulation and ischemia (compromised blood supply). The risk of having a spinal cord injury or a dural tear during spine surgery increases with age as your surgeon needs to cut through toughened spinal ligaments, and in the process, damage the dura. It may also occur in those with previous spine surgery or preexisting spinal cord compression. Surgery to the back of the spine has a higher risk of spinal cord injury or dural tears since it requires cutting through spinal ligaments, which may injure the dura or cord. Special precautions are taken before, during and after surgery to prevent a dural tear or spinal cord injury.

Dural tears are repaired using microsurgical techniques – using a microscope and a fine needle. Small dural tears are sutured or stapled close, while larger ones are reconstructed with a patch or graft. Fat or fibrin glue may be used as a sealant to reinforce the repair. Your surgeon will ensure that the repair is water tight and that the CSF does not leak. Following repair, complete rest is recommended. Fluid pressure on the repair site is minimized by maintaining a sitting or lying position depending on the site of the injury for a period of time.

Spinal cord injury due to trauma requires immediate medical attention to minimize the spread of damage. Your head, neck and back are stabilized to prevent additional injury. Treatment usually involves medication or surgery followed by physical therapy. Surgery may be performed to remove bone fragments, foreign bodies, implants or grafts compressing the spinal cord. Spine stabilization procedures may also be necessary.

Decompression Surgery :: Dural Repair or Other Spinal Cord Repair :: Microdiscectomy :: Minimally Invasive Surgery :: Laminoplasty :: Posterior Surgery :: Revision Surgery :: Spinal Fusion :: Steroid Injections :: Spinal Reconstructive Surgery for Deformities

  • Case Western Reserve University
  • Rothman Institute
  • Jefferson University Hospitals