https://scholars.lib.ntu.edu.tw/handle/123456789/633678
標題: | Cauda equina syndrome caused by the application of DuraSealTM in a microlaminectomy surgery: A case report | 作者: | Yeh, Kuei Lin Wu, Szu Hsien CHIOU-SHANN FUH Huang, Yi Hung CHU-SONG CHEN Wu, Shing Sheng |
關鍵字: | Case report | Cauda equina syndrome | Duraseal | Microlaminectomy | Spinal stenosis | 公開日期: | 26-十月-2022 | 出版社: | BAISHIDENG PUBLISHING GROUP INC | 卷: | 10 | 期: | 30 | 起(迄)頁: | 11178 | 來源出版物: | World Journal of Clinical Cases | 摘要: | BACKGROUND The management of dural tears is important. While a massive dura can be repaired with absorbable suture lines, cerebrospinal fluid leakage can be attenuated by dural sealant when an unintended tiny durotomy occurs intraoperatively. DuraSeal is often used because it can expand to seal tears. This case emphasizes the need for caution when DuraSeal is used as high expansion can cause complications following microlaminectomy. CASE SUMMARY A 77-year-old woman presented with L2/3 and L3/4 lateral recess stenosis. She underwent microlaminectomy, foraminal decompression, and disk height restoration using an IntraSPINE® device. A tiny incident durotomy occurred intraoperatively and was sealed using DuraSeal™. However, decreased muscle power, urinary incontinence, and absence of anal reflexes were observed postoperatively. Emergent magnetic resonance imaging revealed fluid collection causing thecal sac indentation and central canal compression. Surgical exploration revealed that the gel-like DuraSeal had entrapped the hematoma and, consequently, compressed the thecal sac and nerve roots. While we removed all DuraSealTM and exposed the nerve root, the patient’s neurological function did not recover postoperatively. CONCLUSION DuraSeal expansion must not be underestimated. Changes in neurological status require investigation for cauda equina syndrome due to expansion. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/633678 | ISSN: | 2307-8960 | DOI: | 10.12998/wjcc.v10.i30.11178 |
顯示於: | 資訊工程學系 |
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