doi: 10.3389/fsurg.2021.708243.
eCollection 2021.
Affiliations
Affiliations
- 1 Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
- 2 Department of Mathematics, University of Salzburg, Salzburg, Austria.
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Stefan Aspalter et al.
Front Surg.
.
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doi: 10.3389/fsurg.2021.708243.
eCollection 2021.
Affiliations
- 1 Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
- 2 Department of Mathematics, University of Salzburg, Salzburg, Austria.
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Abstract
Background: One of the most frequent complications of spinal surgery is accidental dural tears (ADTs). Minimal access surgical techniques (MAST) have been described as a promising approach to minimizing such complications. ADTs have been studied extensively in connection with open spinal surgery, but there is less literature on minimally invasive spinal surgery (MISS). Materials and Methods: We reviewed 187 patients who had undergone degenerative lumbar spinal surgery using minimally invasive spinal fusions techniques. We analyzed the influence of age, Body Mass Index (BMI), smoking, diabetes, and previous surgery on the rate of ADTs in MISS. Results: Twenty-two patients (11.764%) suffered from an ADT. We recommended bed rest for two and a half to 5 days, depending on the type of repair required and the amount of cerebrospinal fluid (CSF) leakage. We could not find any statistically significant correlation between ADTs and age (p = 0.34,), BMI (p = 0.92), smoking (p = 0.46), and diabetes (p = 0.71). ADTs were significantly more frequent in cases of previous surgery (p < 0.001). None of the patients developed a transcutaneous CSF leak or post-operative infection. Conclusions: The frequency of ADTs in MISS appears comparable to that encountered when using open surgical techniques. Additionally, MAST produces less dead space along the corridor to the spine. Such reduced dead space may not be enough for pseudomeningocele to occur, cerebrospinal fluid to accumulate, and fistula to form. MAST, therefore, provides a certain amount of protection.
Keywords:
cerebrospinal fluid leak; dural tear; minimally invasive surgical procedure; spinal fusion; spine; spine surgery.
Copyright © 2021 Aspalter, Senker, Radl, Aichholzer, Aufschnaiter-Hießböck, Leitner, Stroh, Trutschnig, Gruber and Stefanits.
Conflict of interest statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Franke J, Manson N, Buzek D, Kosmala A, Hubbe U, Rosenberg W, et al. . MASTERS-D study: a prospective, multicenter, pragmatic, observational, data-monitored trial of minimally invasive fusion to treat degenerative lumbar disorders, one-year follow-up. Cureus. (2016) 8:e640. 10.7759/cureus.640
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