{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T11:04:31Z","timestamp":1793703871191,"version":"4.5.1"},"reference-count":54,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>: Retrospective Chart Review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Incidental durotomies (IDs) are common spine surgery complications. In this study, we present a review on the most commonly utilized management strategies, report our institutional experience with case examples, and describe a stepwise management algorithm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was performed of the electronic medical records of all patients who underwent a thoracolumbar or lumbar spine surgery between March 2017 and September 2019. Additionally, a literature review of the current management approaches to treat IDs and persistent postoperative CSF leaks following lumbar spine surgeries was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We looked at 1133 patients that underwent posterior thoracolumbar spine surgery. There was intraoperative evidence of ID in 116 cases. Based on our cohort and the current literature, we developed a progressive treatment algorithm for IDs that begins with a primary repair, which can be bolstered by dural sealants or a muscle patch. If this fails, the primary repair can be followed by a paraspinal muscle flap, as well as a lumbar drain. If the patient cannot be weaned from temporary CSF diversion, the final step in controlling postoperative leak is longterm CSF diversion via a lumboperitoneal shunt. In our experience, these shunts can be weaned once the patient has no further clinical or radiographic signs of CSF leak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is no standardized management approach of IDs and CSF leaks in the literature. This article intends to provide a progressive treatment algorithm and contribute to the development process of a treatment consensus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682221141368","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T06:54:22Z","timestamp":1669359262000},"page":"1316-1327","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Incidental Durotomy Repair in Lumbar Spine Surgery: Institutional Experience and Review of Literature"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4172-8842","authenticated-orcid":false,"given":"Ahmed","family":"Albayar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Spadola","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Blue","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anissa","family":"Saylany","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5201-6720","authenticated-orcid":false,"given":"Mert Marcel","family":"Dagli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Santangelo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connor","family":"Wathen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohannes","family":"Ghenbot","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominick","family":"Macaluso","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zarina S.","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali K.","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Welch","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"bibr1-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2012.01.012"},{"key":"bibr2-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2015.01.001"},{"key":"bibr3-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000559"},{"key":"bibr4-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217717973"},{"key":"bibr5-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1080\/01616412.2016.1261236"},{"key":"bibr6-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-2101-2"},{"key":"bibr7-21925682221141368","doi-asserted-by":"publisher","DOI":"10.3171\/2012.10.SPINE12271"},{"key":"bibr8-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2015.11.045"},{"key":"bibr9-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002822"},{"key":"bibr10-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1177\/2192568220914876"},{"key":"bibr11-21925682221141368","doi-asserted-by":"publisher","DOI":"10.3171\/2011.1.SPINE10426"},{"key":"bibr12-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000182131.44670.f7"},{"key":"bibr13-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000013970"},{"key":"bibr14-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003213"},{"key":"bibr15-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/00024720-200404000-00007"},{"key":"bibr16-21925682221141368","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198163070-00010"},{"key":"bibr17-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2009.03.030"},{"key":"bibr18-21925682221141368","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200710000-00025"},{"key":"bibr19-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-020-06401-y"},{"key":"bibr20-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/WNQ.0b013e31824000ae"},{"key":"bibr21-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000241066.55849.41"},{"key":"bibr22-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-0928-6"},{"key":"bibr23-21925682221141368","doi-asserted-by":"publisher","DOI":"10.21037\/jss-20-519"},{"key":"bibr24-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151533"},{"key":"bibr25-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2005.03.041"},{"key":"bibr26-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1093\/ons\/opx260"},{"key":"bibr27-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjtee.2016.01.008"},{"key":"bibr28-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2005.11.052"},{"key":"bibr29-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)10063-6"},{"key":"bibr30-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199910010-00017"},{"key":"bibr31-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0b013e31827d7ad8"},{"key":"bibr32-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1082313"},{"key":"bibr33-21925682221141368","volume":"27","author":"Kogl N","year":"2020","journal-title":"J Neurosurg Sci"},{"key":"bibr34-21925682221141368","doi-asserted-by":"publisher","DOI":"10.3171\/2014.6.JNS131917"},{"key":"bibr35-21925682221141368","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5413.114937"},{"key":"bibr36-21925682221141368","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2003.15.6.6"},{"key":"bibr37-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199807010-00014"},{"key":"bibr38-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.09.038"},{"key":"bibr39-21925682221141368","first-page":"46","volume":"100","author":"Vitaz TW","year":"2004","journal-title":"J Neurosurg"},{"key":"bibr40-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.04.017"},{"key":"bibr41-21925682221141368","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2003.15.3.13"},{"key":"bibr42-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-84193-x"},{"key":"bibr43-21925682221141368","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2019.01.04"},{"key":"bibr44-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-200002000-00008"},{"key":"bibr45-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-11-53"},{"key":"bibr46-21925682221141368","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2012.6.3.157"},{"key":"bibr47-21925682221141368","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198971070-00004"},{"key":"bibr48-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199202000-00015"},{"key":"bibr49-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2015.05.018"},{"key":"bibr50-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1186\/s41983-021-00298-0"},{"key":"bibr51-21925682221141368","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2020.00057"},{"key":"bibr52-21925682221141368","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(03)00165-4"},{"issue":"2","key":"bibr53-21925682221141368","first-page":"188","volume":"52","author":"Yadav YR","year":"2004","journal-title":"Neurol India"},{"key":"bibr54-21925682221141368","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.63778"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682221141368","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21925682221141368","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682221141368","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:19:18Z","timestamp":1777447158000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21925682221141368"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,25]]},"references-count":54,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1177\/21925682221141368"],"URL":"https:\/\/doi.org\/10.1177\/21925682221141368","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,25]]}}}