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KMID : 0388719940010010102
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Journal of Korean Society of Spine Surgery
1994 Volume.1 No. 1 p.102 ~ p.106
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Treatment of Extensive Dural Defect Occuring with L4, L5 Fractures (A Case Report)
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Abstract
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The dura can be lacerated either in the anterior or the posterior direction in patients with burst fractures of the lumbar spine.
The anterior directions are caused by the retropulsed bony fragments and the posterior directions by the posteriorly displaced dural sac being impaled on the sharp edges of the associated laminar fracture.
The dural tears reported on literatures are mainly posterior directions and watertight primary dural closure is necessary to prevent persistence of cerebrospinal fluid leakage or pseudomeningocele. If primary closure of dura is not possible, a
fascial
graft can be used.
One case of extensive dural defect in patients with L4 burst fracture is reported. The retropulsed bony fragments were reduced with impactor. The extensive dural defect was repaired with dural allograft(Tutoplast(r), Pfimmer Viggo GmbH & Co.
Germany).
Then, the fracture was stabilized in the posterior direction with Cotrel-Dubousset pedicle screw and rod system and posterolateral spinal fusion.
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