{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T18:26:55Z","timestamp":1774290415576,"version":"3.50.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> One of the most frequent complications of spinal surgery is accidental dural tears (ADTs). Minimal access surgical techniques (MAST) have been described as a promising approach to minimizing such complications. ADTs have been studied extensively in connection with open spinal surgery, but there is less literature on minimally invasive spinal surgery (MISS).<\/jats:p><jats:p><jats:bold>Materials and Methods:<\/jats:bold> We reviewed 187 patients who had undergone degenerative lumbar spinal surgery using minimally invasive spinal fusions techniques. We analyzed the influence of age, Body Mass Index (BMI), smoking, diabetes, and previous surgery on the rate of ADTs in MISS.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Twenty-two patients (11.764%) suffered from an ADT. We recommended bed rest for two and a half to 5 days, depending on the type of repair required and the amount of cerebrospinal fluid (CSF) leakage. We could not find any statistically significant correlation between ADTs and age (<jats:italic>p<\/jats:italic> = 0.34,), BMI (<jats:italic>p<\/jats:italic> = 0.92), smoking (<jats:italic>p<\/jats:italic> = 0.46), and diabetes (<jats:italic>p<\/jats:italic> = 0.71). ADTs were significantly more frequent in cases of previous surgery (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). None of the patients developed a transcutaneous CSF leak or post-operative infection.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> The frequency of ADTs in MISS appears comparable to that encountered when using open surgical techniques. Additionally, MAST produces less dead space along the corridor to the spine. Such reduced dead space may not be enough for pseudomeningocele to occur, cerebrospinal fluid to accumulate, and fistula to form. MAST, therefore, provides a certain amount of protection.<\/jats:p>","DOI":"10.3389\/fsurg.2021.708243","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T13:17:05Z","timestamp":1626787025000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Accidental Dural Tears in Minimally Invasive Spinal Surgery for Degenerative Lumbar Spine Disease"],"prefix":"10.3389","volume":"8","author":[{"given":"Stefan","family":"Aspalter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Senker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Radl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Aichholzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathrin","family":"Aufschnaiter-Hie\u00dfb\u00f6ck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemens","family":"Leitner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nico","family":"Stroh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Trutschnig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Gruber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harald","family":"Stefanits","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1055\/s-0030-1247560","article-title":"Minimally invasive approach versus traditional open approach for one level posterior lumbar interbody fusion","volume":"53","author":"Ntoukas","year":"2010","journal-title":"Minim Invasive Neurosurg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1097\/01.brs.0000256473.49791.f4","article-title":"Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach","volume":"32","author":"Park","year":"2007","journal-title":"Spine."},{"key":"B3","doi-asserted-by":"publisher","first-page":"S26","DOI":"10.1097\/00007632-200308011-00006","article-title":"Minimally invasive lumbar fusion","volume":"28","author":"Foley","year":"2003","journal-title":"Spine."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e640","DOI":"10.7759\/cureus.640","article-title":"MASTERS-D study: a prospective, multicenter, pragmatic, observational, data-monitored trial of minimally invasive fusion to treat degenerative lumbar disorders, one-year follow-up","volume":"8","author":"Franke","year":"2016","journal-title":"Cureus."},{"key":"B5","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1089\/lps.1991.1.145","article-title":"Laparoscopic lumbar discectomy: case report","volume":"1","author":"Obenchain","year":"1991","journal-title":"J Laparoendosc Surg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/j.wneu.2020.05.071","article-title":"Evolution of minimally invasive lumbar spine surgery","volume":"140","author":"Momin","year":"2020","journal-title":"World Neurosurg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1097\/BSD.0b013e31802dabd2","article-title":"The frequency and etiology of intraoperative dural tears in 110 predominantly geriatric patients undergoing multi-level laminectomy with noninstrumented fusions","volume":"20","author":"Epstein","year":"2007","journal-title":"J Spinal Disord Tech."},{"key":"B8","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1097\/BSD.0b013e318169026f","article-title":"Minimally invasive interbody fusion for revision lumbar surgery: technical feasibility and safety","volume":"22","author":"Selznick","year":"2009","journal-title":"J Spinal Disord Tech."},{"key":"B9","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1055\/s-0028-1082313","article-title":"Postoperative management of incidental durotomy in minimally invasive lumbar spinal surgery","volume":"51","author":"Than","year":"2008","journal-title":"Minim Invasive Neurosurg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3171\/spi.2002.97.1.0020","article-title":"Spine surgery in morbidly obese patients","volume":"97","author":"Telfeian","year":"2002","journal-title":"J Neurosurg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1728","DOI":"10.2106\/00004623-199812000-00002","article-title":"Dural tears secondary to operations on the lumbar spine. 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