Published online Apr 16, 2023. doi: 10.12998/wjcc.v11.i11.2464
Peer-review started: January 11, 2023
First decision: February 17, 2023
Revised: February 23, 2023
Accepted: March 21, 2023
Article in press: March 21, 2023
Published online: April 16, 2023
Processing time: 85 Days and 7.1 Hours
The late presentation of dural tears (LPDT) has a low incidence rate and hidden symptoms and is easily ignored in clinical practice. If the disease is not treated in time, a series of complications may occur, including low intracranial pressure headache, infection, pseudodural cyst formation, and sinus formation. Here, we describe two cases of LPDT.
Two patients had sudden fever 1 wk after lumbar surgery. Physical examination showed obvious tenderness in the operation area. The patients were confirmed as having LPDT by lumbar magnetic resonance imaging and surgical exploration. One case was caused by continuous negative pressure suction and malnutrition, and the other was caused by decreased dural ductility and low postoperative nutritional status. The first symptom of both patients was fever, with occasional headache. Both patients underwent secondary surgery to treat the LPDT. Dural defects were observed and dural sealants were used to seal the dural defects, then drainage tubes were retained for drainage. After the operation, the patients were treated with antibiotics and the patients’ surgical incisions healed well, without fever or incision tenderness. Both recovered and were discharged 1 wk after the operation.
LPDT is a rare complication of spinal surgery or neurosurgery that has hidden symptoms and can easily be overlooked. Since it may cause a series of complications, LPDT needs to be actively addressed in clinical practice.
Core Tip: Late presentation of dural tears (LPDT) has a low incidence rate and hidden symptoms and is easily overlooked in clinical practice. We describe two cases of LPDT in this paper, and summarize the diagnosis, etiologies and treatment strategies of LPDT through a literature review.