Long-term follow-up of six patients with acute spinal injury following dural decompression

We report six cases of spinal injury in which there was bony encroachment on the spinal cord. At the time of decompression the dura was noted to be tense and non-pulsatile. This method of anterior decompression of burst fractures of the spine suggests that bony decompression of the spinal canal associated with durotomy released the spinal epidural veins which had become congested and had inhibited the free flow of CSF, and we believe also had decreased arteriolar inflow to the cord. Full neurological recovery occurred in three of the six neurologically impaired patients and partial recovery in the remaining three. We believe that a dural decompression may be of some use in preventing a 'compartment syndrome' of the spinal cord. Further animal studies are recommended before the procedure is used routinely.