Repair of dura

What is a dural tear? How do you repair a dural tear? SYNTHECEL Dura Repair is intended for use as a dura replacement for the repair of dura mater in adults. Dural Repair or Other Spinal Cord Repair The spinal cord is covered by three layers of tissue called meninges, the outermost being the dura mater. Dura mater repair , commonly used in neurosurgical procedures, uses dural substitutes to repair defects in the dura.

Dural lesions have been treated successfully through primary repair followed by bed rest in dorsal decubitus. Various forms of repair have been use such as sutures with separate stitches,(5)continuous sutures,(3) autologous fascia grafts , fibrin sealant,(11) and porcine collagen matrix. Then, with the microscope, repaired this with interrupted prolene 5-suture At the end of the report the surgeon then states I would note I took a small fat graft and laid it over the dura , and then a little glue to help assist with the repair.

Incidental durotomy (ID) is one of the most common complications of spine surgery. Gold standard treatment for ID and the best way to prevent persistent cerebrospinal fluid (CSF) leaks is to create a primary sutured repair of the dura. However, suturing can be time consuming, complex and in some cases access to the tear is not possible.

Cranial Repair Products. Do not forget to check for any debridement or repair in the operative note. Dural repair Typically no because the dura should not be opened during a lumbar decompression. Therefore, repair of something you inadvertently did during the procedure is not separately billable. Lyophilized dura mater from human cadavers is often used as a dural substitute, and also in cases of repair of dural defects and meningomyeloceles, but the disadvantage of the transmission of infectious diseases exists.

Repair of the dural opening was achieved in all cases. The polyester fiber mesh was quite effective for dural repair , serving as a scaffold through which a neomembrane grew and united the dural edges. The goals of dural repair include containment of nerve roots and watertight closure to allow early mobilization of the patient. Prevention of meningocele and fistula is also of prime importance.

The actual treatment for an incidental durotomy depends on the size and location of the tear. Zerris VA(1), James KS, Roberts JB, Bell E, Heilman CB. Treatments for dural tears include bed rest, draining, and if the leaking continues, surgery. The surgery for a dural tear is much like plugging a hole in a tire.

Intraoperative Repair. When dural injury occurs and is detected intraoperatively, primary repair is mandatory. Adequate exposure and visualization of the involved area is essential.

The authors’ choice of repair is a simple running suture with tight apposition of the dural edges creating a watertight seal. The dural tear should be repaired using 4-or 6-dural suture with a tapered or reverse cutting needle. The closure can be accomplished with simple interrupted or running locking suture technique. If the tear is too large for primary repair , then a free graft or fascial graft can be used to repair the dural tear.

To achieve a watertight repair and avoid potential post-operative complications the dura is typically closed with sutures. The repair should be tested. In the event that there is a dural deficiency, a dural substitute may be used to replace this membrane.

The large dural tears were repaired with an on-lay graft of muscle, fascia or fat harvested from the.