{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:13:50Z","timestamp":1775801630820,"version":"3.50.1"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Minimally invasive surgery (MIS) has been increasingly used for the treatment of various intradural spinal pathologies in recent years. Although MIS techniques allow for successful treatment of intradural pathology, primary dural closure in MIS can be technically challenging due to a limited surgical corridor through the tubular retractor system. The authors describe their experience with 23 consecutive patients from a single institution who underwent MIS for intradural pathologies, along with a review of pertinent literature.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A retrospective review of a prospectively collected surgical database was performed to identify patients who underwent MIS for intradural spinal pathologies between November 2006 and July 2013. Patient demographics, preoperative records, operative notes, and postoperative records were reviewed. Primary outcomes include operative duration, estimated blood loss, length of bed rest, length of hospital stay, and postoperative complications, which were recorded prospectively.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Twenty-three patients who had undergone MIS for intradural spinal pathologies during the study period were identified. Fifteen patients (65.2%) were female and 8 (34.8%) were male. The mean age at surgery was 54.4 years (range 30\u201374 years). Surgical pathologies included neoplastic (17 patients), congenital (3 patients), vascular (2 patients), and degenerative (1 patient). The most common spinal region treated was lumbar (11 patients), followed by thoracic (9 patients), cervical (2 patients), and sacral (1 patient). The mean operative time was 161.1 minutes, and the mean estimated blood loss was 107.2 ml. All patients were allowed full activity less than 24 hours after surgery. The median length of stay was 78.2 hours. Primary sutured dural closure was achieved using specialized MIS instruments with adjuvant fibrin sealant in all cases. The rate of postoperative headache, nausea, vomiting, and diplopia was 0%. No case of cutaneous CSF fistula or symptomatic pseudomeningocele was identified at follow-up, and no patient required revision surgery.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Primary dural closure with early mobilization is an effective strategy with excellent clinical outcomes in the use of MIS techniques for intradural spinal pathology. Prolonged bed rest after successful primary dural closure appears unnecessary, and the need for watertight dural closure should not prevent the use of MIS techniques in this specific patient population.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.3.spine13719","type":"journal-article","created":{"date-parts":[[2014,5,9]],"date-time":"2014-05-09T14:02:32Z","timestamp":1399644152000},"page":"279-285","source":"Crossref","is-referenced-by-count":36,"title":["Management of intended durotomy in minimally invasive intradural spine surgery"],"prefix":"10.3171","volume":"21","author":[{"given":"Lee A.","family":"Tan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ippei","family":"Takagi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Straus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John E.","family":"O'Toole","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-spine13719","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.1016\/j.spinee.2009.06.012","article-title":"Subdural hematoma after microdiscectomy: a case report and review of the literature","volume":"9","author":"Beier","year":"2009"},{"issue":"389","key":"b2-spine13719","series-title":"Clin Orthop Relat Res","first-page":"238","article-title":"Evaluation and treatment of dural tears in lumbar spine surgery: a review","author":"Bosacco","year":"2001"},{"key":"b3-spine13719","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2663","DOI":"10.1097\/00007632-200010150-00019","article-title":"Incidental durotomy in spine surgery","volume":"25","author":"Cammisa","year":"2000"},{"issue":"5 Suppl 2","key":"b4-spine13719","series-title":"Neurosurgery","first-page":"356","article-title":"Primary dural repair during minimally invasive microdiscectomy using standard operating room instruments","volume":"64","author":"Chou","year":"2009"},{"key":"b5-spine13719","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"160","DOI":"10.3171\/2012.4.SPINE12152","article-title":"Minimally invasive tubular retractor system for adequate exposure during surgical obliteration of spinal dural arteriovenous fistulas with the aid of indocyanine green intraoperative angiography. 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