Incidental Durotomy in Cervical Spinal Surgery

Incidental durotomy complicating cervical spinal surgery is not an uncommon occurrence. While most often these unintentional breeches of the thecal sac do not lead to significant sequelae, there is evidence that they cannot be considered entirely benign events. Meticulous, watertight closure of the dural tear intraoperatively remains the best prevention of continued cerebrospinal fluid egress postoperatively. If complications of dural-cutaneous cerebrospinal fluid fistulas and/or pseudomeningoceles do develop postoperatively, several conservative maneuvers are available. However, a reoperation may still be required as the definitive treatment.

Keywords: cervical, durotomy, cerebrospinal fluid fistula, pseudomeningocele, intracranial hypotension