Management of CSF Leak Following Incidental Durotomy during Lumbar Spinal Surgery: Is Flat Bed Necessary?

Abstract

Incidental durotomy (ID) is a term used to describe unintentional opening of the duramater during spinal surgery. Although, commonly referred to as dural tear; most recent scholars are circumventing the use of the latter term, as it could imply an element of carelessness when none were necessarily present. Therefore, ID, unintended durotomy, unintentional durotomy or simply just dural opening, have been recommended to replace the term dural tear. The reported incidence of ID of spinal surgeries ranges from 0.1-13.7%. Despite being one of the most common complications of spinal surgery, it remains often underreported because of the lack of morbidity in the most of cases. ID is often associated with cerebrospinal fluid (CSF) leakage from the subarachnoid space through the dural defect.