Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration
This surgical video demonstrates the full-endoscopic repair of an incidental durotomy, offering practical guidance and insights into the technique. Incidental dural tears occur in up to 1% of lumbar endoscopic surgeries, with risk factors including interlaminar approaches, stenosis decompression, an...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Spinal Neurosurgery Society
2024-12-01
|
| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://e-neurospine.org/upload/pdf/ns-2449054-527.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849739582832115712 |
|---|---|
| author | Warayos Trathitephun Jackapol Kamolpak Siravich Suvithayasiri |
| author_facet | Warayos Trathitephun Jackapol Kamolpak Siravich Suvithayasiri |
| author_sort | Warayos Trathitephun |
| collection | DOAJ |
| description | This surgical video demonstrates the full-endoscopic repair of an incidental durotomy, offering practical guidance and insights into the technique. Incidental dural tears occur in up to 1% of lumbar endoscopic surgeries, with risk factors including interlaminar approaches, stenosis decompression, and power drill usage. Although many dural tears are managed with sealant or gel foam, no standard exists for when surgical repair is necessary. Complications such as cerebrospinal fluid leakage, radiculopathy, and neurological deficits can arise, prompting the need for effective repair techniques. A 50-year-old man presented with bilateral leg claudication due to lumbar stenosis (L4–S1). Full-endoscopic decompression was performed, during which an incidental 10-mm dural tear occurred at L5–S1. The nerve root was repositioned into the dural sac, and the tear was repaired using a 6-0 prolene suture with a knot pusher under endoscopic guidance. Gelfoam was applied to aid compression, and irrigation pressure was reduced to prevent increased intracranial pressure. The patient was mobilized after 48 hours and experienced significant symptom improvement without neurological deficits. We propose that dural tears should be repaired when possible to prevent complications. Surgeon experience, tear size, and location are critical factors. This case demonstrates a simple, effective endoscopic repair method, though further studies are needed to establish its long-term efficacy. |
| format | Article |
| id | doaj-art-eaf3df0022c64553b652ec1e78950fca |
| institution | DOAJ |
| issn | 2586-6583 2586-6591 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj-art-eaf3df0022c64553b652ec1e78950fca2025-08-20T03:06:14ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912024-12-012141102110510.14245/ns.2449054.5271647Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video DemonstrationWarayos Trathitephun0Jackapol Kamolpak1Siravich Suvithayasiri2 Department of Orthopedics, Chulabhorn Hospital, Bangkok, Thailand Department of Orthopedics, Chulabhorn Hospital, Bangkok, Thailand Department of Orthopedics, Chulabhorn Hospital, Bangkok, ThailandThis surgical video demonstrates the full-endoscopic repair of an incidental durotomy, offering practical guidance and insights into the technique. Incidental dural tears occur in up to 1% of lumbar endoscopic surgeries, with risk factors including interlaminar approaches, stenosis decompression, and power drill usage. Although many dural tears are managed with sealant or gel foam, no standard exists for when surgical repair is necessary. Complications such as cerebrospinal fluid leakage, radiculopathy, and neurological deficits can arise, prompting the need for effective repair techniques. A 50-year-old man presented with bilateral leg claudication due to lumbar stenosis (L4–S1). Full-endoscopic decompression was performed, during which an incidental 10-mm dural tear occurred at L5–S1. The nerve root was repositioned into the dural sac, and the tear was repaired using a 6-0 prolene suture with a knot pusher under endoscopic guidance. Gelfoam was applied to aid compression, and irrigation pressure was reduced to prevent increased intracranial pressure. The patient was mobilized after 48 hours and experienced significant symptom improvement without neurological deficits. We propose that dural tears should be repaired when possible to prevent complications. Surgeon experience, tear size, and location are critical factors. This case demonstrates a simple, effective endoscopic repair method, though further studies are needed to establish its long-term efficacy.http://e-neurospine.org/upload/pdf/ns-2449054-527.pdffull-endoscopic spinal surgeryuniportal endoscopyincidental durotomyendoscopic dural suture repaircomplication |
| spellingShingle | Warayos Trathitephun Jackapol Kamolpak Siravich Suvithayasiri Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration Neurospine full-endoscopic spinal surgery uniportal endoscopy incidental durotomy endoscopic dural suture repair complication |
| title | Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration |
| title_full | Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration |
| title_fullStr | Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration |
| title_full_unstemmed | Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration |
| title_short | Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration |
| title_sort | practical guidance of full endoscopic technique for incidental durotomy repair a surgical video demonstration |
| topic | full-endoscopic spinal surgery uniportal endoscopy incidental durotomy endoscopic dural suture repair complication |
| url | http://e-neurospine.org/upload/pdf/ns-2449054-527.pdf |
| work_keys_str_mv | AT warayostrathitephun practicalguidanceoffullendoscopictechniqueforincidentaldurotomyrepairasurgicalvideodemonstration AT jackapolkamolpak practicalguidanceoffullendoscopictechniqueforincidentaldurotomyrepairasurgicalvideodemonstration AT siravichsuvithayasiri practicalguidanceoffullendoscopictechniqueforincidentaldurotomyrepairasurgicalvideodemonstration |