J Korean Soc Spine Surg.  1997 Nov;4(2):232-239.

Dural Tears in the Thoracolumbar Fractures

• Rhyu KW
• Kang YK
• Lee HY
• Koh HS
• Song JH
• Kim JH

Abstract

STUDY DESIGN: The authors reviewed the dural tears in the thoracolumbar fractures treated surgically.
OBJECTIVES
To evaluate the incidence and the predictive values for the presence of dural tears in the thoracolumbar fractures. SUMMARY OF LITERATURE REVIEW: Many authors reported that the dural tear was usually related to the thoracolumbar fractures especially with laminar fracture and neurologic deficit. The dural tears may lead complications such as the entrapment of spinal nerve root, delayed wound healing, cerebrospinal fluid fistula, and myelomeningocele. Previous reports emphasized posterior approach to confirm and treat the dural tears using laminectomy. So it is very important that surgeons should identify the presence of dural tear preoperatiyely to determine the surgical approach and treatment options.
MATERIALS AND METHODS
The authors reviewed 22 patients of thoracolumbar fractures treated with posterior laminectomy, posterior decompression, posterolateral fusion, and instntmentation from August 1993 to August 1996. The follow-up period was minimally 12 months. We checked the canal compromise, the injury of the posterior column including laminar fracture and ligamental injury, and neurologic deficits as the predictive values. The statistical analysis was done to evaluate the relationship between the dural tear and the predictive values.
RESULTS
The incidence of dural tear was 54.4% of the thoracolumbar fractures. The canal encroachment, the injury of the posterior column, and the neurologic deficits were not significantly related with the dural tears in statistical analysis. But we could find the tendency that is related to the dural tear and posterior column injury.
CONCLUSION
The authors concluded that we could find the possible presence of dural tears in the severe thoracoiumbar which were needed the surgical treatment and we could suggest the injury of posterior column was a possible value that could predict the presence of dural tear.

MeSH Terms

Cerebrospinal Fluid
Decompression
Fistula
Follow-Up Studies
Humans
Incidence
Laminectomy
Ligaments
Meningomyelocele
Neurologic Manifestations
Spinal Nerve Roots
Tears*
Wound Healing