Review of Intraoperative Durotomies in Spinal Surgery and Its Management Strategies with Current Advances in Treatment

Abstract

Intraoperative durotomies in spinal surgeries can have potentially serious consequences if not appropriately addressed. They result from an opening in the dural-arachnoid membrane around the spinal cord, cauda equina or nerve root sleeve. Most causes are iatrogenic, and if not properly addressed or go unnoticed, patients may present with complications such as postural headache, wound breakdown, meningitis, and even death. Magnetic resonance imaging is the diagnostic study of choice, with treatment options ranging from observation, bed rest, and/or epidural blood patch to lumbar subarachnoid drainage, and surgical repair.