A novel two-layer, intradural and extradural patch graft approach to treating dural defects and tears: illustrative case.
| Autor: | Lazarus D; 1Jenkins NeuroSpine, New York, New York; and., Hawks C; 1Jenkins NeuroSpine, New York, New York; and., Kumar N; 1Jenkins NeuroSpine, New York, New York; and., McCaffrey T; 1Jenkins NeuroSpine, New York, New York; and., Jenkins AL; 1Jenkins NeuroSpine, New York, New York; and.; Departments of2Orthopedics and.; 3Neurosurgery, Icahn School of Medicine, The Mount Sinai Hospital, New York, New York. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2022 Feb 07; Vol. 3 (6). Date of Electronic Publication: 2022 Feb 07 (Print Publication: 2022). |
| DOI: | 10.3171/CASE21639 |
| Abstrakt: | Background: Dural tears must be quickly addressed to avoid the development of positional headaches and pseudomeningoceles, among other complications. However, sizeable areas of friable or absent dura create unique challenges when attempting to achieve a watertight seal. We have developed a two-layer subdural and epidural fibrous patch technique to treat expansive or challenging dural tears as a result of our experience treating spinal fluid leaks. Observations: The authors present the treatment of a large necrotic (5 × 1.5 cm) dural defect refractory to initial attempts at standard primary repair with dural patch grafting and requiring a revision with a dual-layer patch to manage persistent cerebrospinal fluid leakage. Lessons: The use of a two-layer (subdural and epidural) patch is both a safe and effective dural repair technique for creating a watertight seal in challenging large areas in which the dura may be damaged, scarred, or absent. We also propose that this technique may be able to be used for smaller challenging tears, as well as potentially for repairs of large blood vessels or other fluid-filled structures in the body. |
| Databáze: | MEDLINE |
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