Unrecognized dural tear during percutaneous endoscopic lumbar surgery confirmed with myelography

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

Radiology Case Reports (Sep 2023)

Unrecognized dural tear during percutaneous endoscopic lumbar surgery confirmed with myelography

Shu Takeuchi, MD,
Junya Hanakita, MD, PhD,
Toshiyuki Takahashi, MD, PhD,
Ryo Kanematsu, MD,
Izumi Suda, MD,
Sho Nakamura, MD,
Manabu Minami, MD, PhD

Affiliations

Shu Takeuchi, MD: Department of Neurosurgery, National Cerebral and Cardiovascular Center Hospital, 6-1, Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan; Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan; Corresponding author.
Junya Hanakita, MD, PhD: Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan
Toshiyuki Takahashi, MD, PhD: Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan
Ryo Kanematsu, MD: Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan
Izumi Suda, MD: Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan
Sho Nakamura, MD: Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan
Manabu Minami, MD, PhD: Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan

Journal volume & issue: Vol. 18, no. 9
pp. 2992 – 2994

Abstract

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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.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: http://www.journals.elsevier.com/radiology-case-reports/

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