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Prevalence and characteristics of microspurs in patients with spontaneous intracranial hypotension compared to the general population.
AJNR Am J Neuroradiol
January 2025
From the Department of Neurosurgery (D.N., L.H., J.G., T.P., R.T.S., A.R., C.M.J.); Department of Neuroradiology (T.D., E.I.P.), Institute of Diagnostic and Interventional Neuroradiology, and Department of Neurology (C.S.), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Department of Neurosurgery (J.B.), Medical Center, University of Freiburg, Freiburg, Germany.
Background And Purpose: In patients diagnosed with spontaneous intracranial hypotension (SIH), microspurs are considered the culprit lesion in most ventral dural leaks (type I). The imaging characteristics of discogenic spurs, and their prevalence in the general population has not been reported in the literature.
Materials And Methods: This observational case-control study was conducted comparing the prevalence and characteristics of discogenic microspurs between SIH patients with a type I leak treated at a tertiary hospital between 2013 and 2023 and an age-and sex matched cohort of trauma patients.
Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration.
Neurospine
December 2024
Department of Orthopedics, Chulabhorn Hospital, Bangkok, Thailand.
This surgical video demonstrates the full-endoscopic repair of an incidental durotomy, offering practical guidance and insights into the technique. Incidental dural tears occur in up to 1% of lumbar endoscopic surgeries, with risk factors including interlaminar approaches, stenosis decompression, and power drill usage. Although many dural tears are managed with sealant or gel foam, no standard exists for when surgical repair is necessary.
View Article and Find Full Text PDFIncidental durotomy in lumbar decompressive surgery: incidence and risk-factors, and the effect of durotomy on hospital and patient metrics.
Eur Spine J
December 2024
Consultant Spinal Surgeon, Spire Norwich Hospital, Norwich, UK.
Purpose: To evaluate incidental lumbar durotomy incidence and risk-factors, and the association of durotomy with perioperative metrics and patient-reported outcomes.
Methods: A total 3140 cases of 1-3 level elective decompressive surgery from 2008 to 2023 at a single centre were included. Multivariable analysis was performed on literature derived variables to identify independent risk-factors for durotomy.
Right Drug in the Wrong Place: The Effects of Inadvertent Intrathecal Tranexamic Acid.
Cureus
October 2024
Anesthesiology, Unidade Local de Saúde da Região de Aveiro, Aveiro, PRT.
Tranexamic acid (TXA) is an antifibrinolytic drug widely used to reduce blood loss in major surgeries and trauma patients, thus reducing morbimortality. In recent years, clinical indications for TXA have expanded, including many off-label uses. This broad use has led to an increased incidence of reported side effects and administration errors with serious neurological and cardiovascular outcomes, such as seizures, myoclonus, and arrhythmias.
View Article and Find Full Text PDFApplication of Using Gore Preclude MVP Dura Substitute for Intraoperative Durotomy Repair in Lumbar Spine Surgery: Case Series and A Technical Note.
Asian J Neurosurg
December 2024
Department of Neurosurgery, Otsu City Hospital, Otsu, Shiga, Japan.
Article Synopsis
- * This study outlines a repair method using the Gore Preclude MVP Dura Substitute, a three-layer artificial material that effectively closes the dural opening.
- * The procedure involved placing a larger piece of MVP in the durotomy area, securing it with nylon yarn, which successfully prevented any leaks and resulted in no complications during the process.
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