Dural Tears Causing FBSS

The spine is one of the most delicate parts of the body. One tiny mistake, and the patient can have severe, worsening pain that requires additional surgery or immediate treatment.

Dural Tears After Spine Surgery

Covering the spinal cord is a series of membranes: sheet-like layers that protect the spinal cord and all its nerves and fluids. During almost any type of spine surgery, it’s not uncommon for a surgeon to accidentally make a small cut on the outer later, known as the “Dural-Mater.”

These cuts and tears are not usually a problem. The surgeon sees the cut, treats it, and it usually heals without issue. But problems occur when the surgeon does not notice a cut in the dural-mater and finishes surgery. Blood does not pass through the spinal cord naturally, and since blood flow is necessary to clot and heal wounds, the dural mater cannot heal on its own.

One of the main roles of the dural mater is to hold in spinal fluid. If your spine still has a dural tear, your spinal cord will leak this cerebrospinal fluid over time. This results in symptoms that include:

• Spinal Headache – Severe headache that may disappear when laying down.
• Spinal Meningitis – Sensitivity to light, fever, fatigue, headache, vomiting, and possibly seizures.
• Neurological Deficit – Including trouble thinking, hearing strange sounds, tinnitus, and others.

There are also several diseases and issues that may come from CSF leaks, including CSF fistula formation, pseudomeningocele, arachnoiditis and epidural abscess. Spinal headaches, however, are the hallmark of this issue, and pop up roughly 3 days after the dural tear.

Treatment of Dural Tears

Dural tears may occur during surgery, but are treated fairly easily by the surgeon. But when the dural tear is missed, immediate treatment is usually necessary. Options include:

• “Blood Patch” – Injecting a small amount of your own blood near the tear can trigger clotting factors that will seal the tear and prevent future CSF leaking.
• Reoperation – Immediate reoperation may also be recommended. By undergoing an emergency surgery, some of the worst issues can be prevented, and the pain can be addressed immediately.
• Synthetic Collagen Grafting – Like blood patches, collagen grafting has been shown to have a high success rate at repairing dural tears.

Most surgeons agree, however, that a dural tear is something that requires an immediate treatment. Dural tears of the subarachnoid space simply do not seem to heal successfully on their own.

If you believe you may have experienced a dural tear, we recommend you call Spine Center Atlanta today at 404-620-5523, and let our surgeons and specialists help you overcome your FBSS.