Kim Young-Jin
Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.
Korean J Spine. 2017 Sep;14(3):103-105. doi: 10.14245/kjs.2017.14.3.103. Epub 2017 Sep 30.
Incidental durotomies are a frequent complication during spinal surgery. Cerebrospinal fluid (CSF) leakage from a dural tear may be visually apparent intraoperatively, but occasionally, a tear may not be recognized during the procedure. We report our experience in 2 cases of postoperative incarceration of nerve root as a cause of sciatica, without CSF leakage intraoperatively. When durotomy attributable to surgical manipulation does occur, intraoperative identification is mandated. If a patient develops unexplainable postoperative pain and neurological deficits after lumbar discectomy, incarceration of nerve root should be considered in the differential diagnosis.
术中意外硬脊膜切开是脊柱手术中常见的并发症。硬脊膜撕裂导致的脑脊液(CSF)漏在术中可能肉眼可见,但偶尔在手术过程中可能未识别出撕裂。我们报告了2例术后神经根嵌顿导致坐骨神经痛的病例,术中无脑脊液漏。当因手术操作导致硬脊膜切开时,术中必须进行识别。如果患者在腰椎间盘切除术后出现无法解释的术后疼痛和神经功能缺损,在鉴别诊断中应考虑神经根嵌顿。