Dural Injury During Spinal Surgery and Postoperative Cerebrospinal Fluid Leakage: A Single-Center Experience

The incidence of dural injury during spinal surgery and postoperative cerebrospinal fluid leakage varies between studies. We examined these rates in our institution.

Among 4014 patients who underwent a spinal operation between January 2012 and February 2020, 176 experienced an intraoperative dural injury (176 of 4014 cases, 4.3%). Among these, 22 (22 of 176 cases, 12.5%) developed postoperative cerebrospinal fluid leakage.

The cause of dural injury was identified in 74 of 176 patients (42%). The rates of dural injury associated with thoracic, cervical, and lumbar operations were 7.8% (25 of 321 cases), 3.2% (19 of 602 cases), and 4.3% (132 of 3091 cases), respectively. Corresponding rates of cerebrospinal fluid leakage were 28% (seven of 25 cases), 5.3% (one of 19 cases), and 11% (14 of 132 cases), respectively. Most patients who experienced cerebrospinal fluid leakage recovered with bed rest; however, cerebral hemorrhage occurred in two patients.

Although it was difficult to identify the cause of dural injury in more than half of patients, suturing the dura and using polyglycolic acid mesh with fibrin glue was effective. No patients required reoperation, even those who developed cerebrospinal fluid leakage.