Dural Tear During Thoracic Laminectomy Using Craniotome With Footplate Attachment

Area of Science:

• Neurosurgery
• Spinal Surgery

Background:

• Laminectomy is a surgical procedure to remove a portion of a vertebra.
• The craniotome with a footplate attachment is an alternative to traditional methods like high-speed drills and Kerrison rongeurs for laminectomy.
• This technique offers advantages in speed and reduced bone destruction, beneficial for procedures like laminoplasty.

Purpose of the Study:

• To highlight the complication of dural laceration associated with the craniotome footplate laminectomy technique.
• To emphasize proper surgical technique to mitigate risks.
• To report a case of dural laceration during laminectomy for an intramedullary spinal cord tumor.

Main Methods:

• A case report of a 48-year-old male undergoing T7-10 laminectomy for an intramedullary spinal cord tumor.
• Description of a dural laceration occurring during the upward cut of the hemi-lamina at T7-9.
• Details of the surgical repair involving a dural patch, fat graft, and lumbar drain.

Main Results:

• A dural laceration occurred during the laminectomy procedure.
• The laceration was not amenable to direct suture closure and required a dural patch and fat graft for repair.
• The patient's case illustrates a potential complication of the craniotome footplate technique.

Conclusions:

• While the craniotome footplate technique offers advantages in speed and bone preservation for laminectomy and laminoplasty, surgeons must be aware of the risk of dural laceration.
• Proper initial placement of the footplate, ensuring it is seated under the inferior aspect of the lamina and over the ligamentum flavum, is crucial.
• Avoiding directing the footplate beyond the laminae and facet borders can prevent dura and nerve root injury.