Unrecognized dural tear during percutaneous endoscopic lumbar surgery confirmed with myelography

Shu Takeuchi; Junya Hanakita; Toshiyuki Takahashi; Ryo Kanematsu; Izumi Suda; Sho Nakamura; Manabu Minami

doi:10.1016/j.radcr.2023.05.062

Unrecognized dural tear during percutaneous endoscopic lumbar surgery confirmed with myelography

Radiol Case Rep. 2023 Jun 20;18(9):2992-2994. doi: 10.1016/j.radcr.2023.05.062. eCollection 2023 Sep.

Authors

Shu Takeuchi^{1

2}, Junya Hanakita², Toshiyuki Takahashi², Ryo Kanematsu², Izumi Suda², Sho Nakamura², Manabu Minami²

Affiliations

¹ Department of Neurosurgery, National Cerebral and Cardiovascular Center Hospital, 6-1, Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
² Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan.

Abstract

Iatrogenic dural tear is usually recognized during the surgery. We describe a rare case of unrecognized dural tear caused by percutaneous endoscopic lumbar surgery at another hospital clearly confirmed with dynamic myelography. Although magnetic resonance imaging of the lumbar spine showed no obvious fluid collection suggesting dural tear, dynamic myelography revealed leakage of intradural subarachnoid contrast medium along root sleeve into the intervertebral disc space. In the setting of endoscopic spine surgery, incidental dural tear might be overlooked due to the narrow and fluid-filled surgical field. Dynamic myelography is useful to evaluate the precise condition caused by unrecognized dural tear.

Keywords: Dural tear; Endoscopic surgery; Lumbar disc herniation; Myelography.

Publication types

Case Reports