Treatment of dural tears associated with spinal surgery

We reviewed the cases of five consecutive patients with tears of the spinal dura with postoperative leaks of cerebrospinal fluid. Problems in cluded the persistence of cerebrospinal-fluid fistulas in four patients and a late symptomatic pseudomeningocele in one, all requiring reoperation and meticulous closure of the dura. Dural tears should be repaired at the time of the original operation either directly or utilizing a fascial graft or a tissue-plug technique. When the leak is first noted in the postoperative period, reoperation for repair of the dura is recommended.