Management of CSF Leak Following Incidental Durotomy during Lumbar Spinal Surgery: Is Flat Bed Necessary?

Abstract

Incidental durotomy (ID) is a term used to describe unintentional opening of the dura
mater during spinal surgery. Although, commonly referred to as dural tear; most recent scholars
are circumventing the use of the latter term, as it could imply an element of carelessness when
none were necessarily present. Therefore, ID, unintended durotomy, unintentional durotomy or
simply just dural opening, have been recommended to replace the term dural tear.1,2
The reported incidence of ID of spinal surgeries ranges from 0.1-13.7%. Despite being
one of the most common complications of spinal surgery, it remains often underreported
because of the lack of morbidity in the most of cases.3 ID is often associated with cerebrospinal
fluid (CSF) leakage from the subarachnoid space through the dural defect.1