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World J Clin Cases. May 6, 2023; 11(13): 2903-2915
Published online May 6, 2023. doi: 10.12998/wjcc.v11.i13.2903
Clinical management of dural defects: A review
Rong-Peng Dong, Qi Zhang, Li-Li Yang, Xue-Liang Cheng, Jian-Wu Zhao
Rong-Peng Dong, Qi Zhang, Li-Li Yang, Xue-Liang Cheng, Jian-Wu Zhao, Department of Spinal Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
Author contributions: Dong RP, Zhang Q contributed to this paper with design of the study, literature review and analysis, and manuscript drafting; Yang LL collected relevant information; Zhao JW and Cheng XL guided the writing and reviewing of this paper and put forward suggestions for the article; all authors have read and approved the final manuscript.
Supported by Jilin Health Science and Technology Capability Improvement Project, No. 2022C107.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
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, Nanguan District, Changchun 130000, Jilin Province, China. jianwu@jlu.edu.cn
Received: December 28, 2022
Peer-review started: December 28, 2022
First decision: February 20, 2023
Revised: March 3, 2023
Accepted: April 4, 2023
Article in press: April 4, 2023
Published online: May 6, 2023
Processing time: 118 Days and 1.5 Hours
Abstract

Dural defects are common in spinal and cranial neurosurgery. A series of complications, such as cerebrospinal fluid leakage, occur after rupture of the dura. Therefore, treatment strategies are necessary to reduce or avoid complications. This review comprehensively summarizes the common causes, risk factors, clinical complications, and repair methods of dural defects. The latest research progress on dural repair methods and materials is summarized, including direct sutures, grafts, biomaterials, non-biomaterial materials, and composites formed by different materials. The characteristics and efficacy of these dural substitutes are reviewed, and these materials and methods are systematically evaluated. Finally, the best methods for dural repair and the challenges and future prospects of new dural repair materials are discussed.

Keywords: Dural defect; Cerebrospinal fluid leak; Incidental durotomy; Causes of dural defect; Dural repair

Core Tip: Dural defects are common in spinal surgery and may cause a series of complications, so it is necessary to actively prevent and treat them. In this paper, we reviewed issues related to dural defects and discussed their clinical management.