Thecal sac ligation in the setting of thoracic spondyloptosis with complete cord transection.

Autor:	Vazquez S; Department of Neurosurgery, School of Medicine, New York Medical College, Valhalla, United States., Houten JK; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, New York, United States., Stadlan ZT; Department of Neurosurgery, School of Medicine, New York Medical College, Valhalla, United States., Greisman JD; Department of Neurosurgery, School of Medicine, New York Medical College, Valhalla, United States., Vaserman G; Department of Neurosurgery, School of Medicine, New York Medical College, Valhalla, United States., Spirollari E; Department of Neurosurgery, School of Medicine, New York Medical College, Valhalla, United States., Sursal T; Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, United States., Dominguez JF; Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, United States., Kinon MD; Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, United States.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2023 Sep 01; Vol. 14, pp. 304. Date of Electronic Publication: 2023 Sep 01 (Print Publication: 2023).
DOI:	10.25259/SNI_360_2023
Abstrakt:	Background: Traumatic spondyloptosis (TS) with complete spinal cord transection and unrepairable durotomy is particularly rare and can lead to a difficult-to-manage cerebrospinal fluid (CSF) leak. Methods: We performed a systematic review of the literature on TS and discuss the management strategies and outcomes of TS with cord transection and significant dural tear. We also report a novel case of a 26-year-old female who presented with thoracic TS with complete spinal cord transection and unrepairable durotomy with high-flow CSF leak. Results: Of 93 articles that resulted in the search query, 13 described cases of TS with complete cord transection. The approach to dural repair was only described in 8 ( n = 20) of the 13 articles. The dura was not repaired in two (20%) of the cases. Ligation of the proximal end of the dural defect was done in 15 (75%) of the cases, all at the same institution. One (5%) case report describes ligation of the distal end; one (5%) case describes the repair of the dura with duraplasty; and another (5%) case describes repair using muscle graft to partially reconstruct the defect. Conclusion: Suture ligation of the thecal sac in the setting of traumatic complete spinal cord transection with significant dural disruption has been described in the international literature and is a safe and successful technique to prevent complications associated with persisting high-flow CSF leakage. To the best of our knowledge, this is the first report of thecal sac ligation of the proximal end of the defect from the United States. Competing Interests: There are no conflicts of interest. (Copyright: © 2023 Surgical Neurology International.)
Databáze:	MEDLINE
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