• World Neurosurg · Feb 2020

    Incidence and Implications of Incidental Durotomy in Transforaminal Endoscopic Spine Surgery: Case Series.

    • Albert E Telfeian, Jian Shen, Rohaid Ali, Adetokunbo Oyelese, Jared Fridley, and Ziya L Gokaslan.
    • The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. Electronic address: ATelfeian@Lifespan.org.
    • World Neurosurg. 2020 Feb 1; 134: e951-e955.

    ObjectiveTo evaluate the incidence and outcomes of incidental durotomy in transforaminal endoscopic spine surgery.MethodsTransforaminal lumbar endoscopic procedures were performed by 2 surgeons in 907 patients over a period of 4 years from 2014 to 2018. Patient data were evaluated retrospectively in these patients with a minimum follow-up of 1 year.ResultsIn 907 patients over 4 years there were 5 durotomies: 4 incidental and 1 intentional. The rate for incidental durotomy was therefore 0.4%. There were no adverse outcomes from the incidental durotomies, and only 1 patient noted a headache.ConclusionsIncidental durotomy is a rare complication of transforaminal lumbar endoscopic spine surgery and appears to occur more likely in patients who have undergone previous spine surgery at the site of the endoscopic procedure, not unexpectantly. Glues, patches, and bedrest were among the various methods used after durotomy. In this series there were no cases of symptomatic spinal fluid leakage or pseudomeningocele seen. Only 20% of patients who had durotomies noted a headache in the immediate postoperative period.Copyright © 2019 Elsevier Inc. All rights reserved.

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