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KMID : 1001920130530010052
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Journal of Korean Neurosurgical Society
2013 Volume.53 No. 1 p.52 ~ p.56
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Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases
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Choi Jeong-Hoon
Kim Jin-Sung
Jang Jee-Soo
Lee Dong-Yeob
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Abstract
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Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients’ symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.
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KEYWORD
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Nerve rootlet entrapment, Lumbar disc herniation, Laminectomy, Discectomy, Dura tear, Dura repair
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