Xu C, Dong RP, Cheng XL, Zhao JW. Late presentation of dural tears: Two case reports and review of literature. World J Clin Cases 2023; 11(11): 2464-2473 [PMID: 37123324 DOI: 10.12998/wjcc.v11.i11.2464]
Corresponding Author of This Article
Jian-Wu Zhao, MD, PhD, Chief Doctor, Professor, Department of Spinal Surgery, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130012, Jilin Province, China. jianwu@jlu.edu.cn
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Chang Xu, Department of Orthopedics, Jilin Provincial Armed Police Corps Hospital, Changchun 130000, Jilin Province, China
Rong-Peng Dong, Xue-Liang Cheng, Jian-Wu Zhao, Department of Spinal Surgery, The Second Hospital of Jilin University, Changchun 130012, Jilin Province, China
Author contributions: Xu C and Dong RP contributed to manuscript writing and editing, and data collection; Cheng XL and Zhao JW contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Supported byJilin Health Science and Technology Capability Improvement Project, No. 2022C107.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Wu Zhao, MD, PhD, Chief Doctor, Professor, Department of Spinal Surgery, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130012, Jilin Province, China. jianwu@jlu.edu.cn
Received: January 11, 2023 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
