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Thread: Questions about Dural Decompensation

  1. #1
    Join Date
    Apr 2012
    Location
    Harrisburg, Pa.
    Posts
    85

    Questions about Dural Decompensation

    Hi Everyone....11 days from surgery. I need some support here. I received a call from the doctor's nurse yesterday. The doctor has not decided on how many levels he is going to fuse until he sees how much bone and my synovial cyst could be attached to the dura....the dura is the outer covering of the spinal canal....if the dura tears at the point where the L4-L5 needs decompressed or where the cyst needs removed, the doctor will suture it. The more places the dura tears, the higher risk of losing spinal canal fluid. I was hoping I would be fused from L2-sacrum but now it depends on what he finds when going in. Of course, I told the doctor's nurse that I will certainly depend totally on his expertise to make those decisions even though I was hoping I could be fused to the sacrum....a once and done deal. Do any of you, especially Linda and TitaniumEd, have any experience or information regarding the dura and have any of you had experience with your doctor having to suture the dura? I am a little worried about this even though I have one of the best doctors around and then worried if he only fuses L4-L5, I will still have problems at L2-L3, L3-L4 and L5-S1. Ed, did you have severe lateral stenosis in the lumbar area. The nurse is saying when severe lateral stenosis is involved, there is a much better chance some of the bone is attached to the dura. Thanks everyone for your input.....11 days to go!!!!

    Patty
    1963 Fusion T4-L2 for congenital scoliosis. It was a bone graft and not instrumentation
    1989 to Present....Have had chronic pain. MRI's show severe neural foraminal stenosis L2-S1, rotational scoliosis lumbar spine over 40 degrees, compression of nerve roots L5-S1, Broad Based Herniations L4-L5, L5-S
    Surgery scheduled with Dr. Bridwell on December 11, 2012
    December 11, 2012 Had surgery with Dr. Bridwell. He fused L4-L5 with rods and screws.

  2. #2
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,557
    Patty

    Its not worth worrying about these things....things that are beyond your control. I personally did not have a dural tear, or any outstanding stenosis issues....Many of the calls are done once they get in, and with many factors at play, all we can do is hang in there and see how things go. You have an outstanding surgeon who has been around the block a few times. Believe and trust in him. Im sure you will be fine.

    http://www.ncbi.nlm.nih.gov/pubmed/20810935


    Ed
    49 yr old male, now 59, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  3. #3
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    766
    Hi Patty,
    I had experience with this. The dura tore 4 times in my 1st surgery. And was repaired 4 times. All turned out Ok. I believe the drs know this may happen and know what to do. I do recall a major headache the next day---at the time I did not know about the problems that the Dr had---I just thought the headache was from such a long surgery. Your Dr is just being prepared for what he may face. Private message me and I will give you more info.

  4. #4
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,802
    Hi Patty...

    Dural tears aren't exactly commonplace, but they definitely*are one of the more common complications (more in revision surgery). I had dural tears in both of my surgeries. I suspect that Dr. Bridwell would not do your surgery if he felt that there was too big a risk.

    Hang in there. There are lots of thing about which you can stress, but the stress just makes it worse. Try to relax if you can. If something bad happens, you'll deal with it when it presents itself.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  5. #5
    Join Date
    Mar 2008
    Location
    New Bern, NC
    Posts
    1,445
    My grandson had a dural tear from a spinal tap when he had Lime disease. Poor kid, he had a major headache for a week before a doctor figured out what was happening. In his case, it was a simple repair with blood drawn in a tube with no anticoagulant and that blood was placed at the site of the tear. The blood clotted and sealed up the hole. Who knew!
    You will be fine Patty. You have one of the best Docs.
    Sally
    Diagnosed with severe lumbar scoliosis at age 65.
    Posterior Fusion L2-S1 on 12/4/2007. age 67
    Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
    Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
    New England Baptist Hospital, Boston, MA
    Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

    "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

  6. #6
    Join Date
    May 2008
    Location
    Central NJ
    Posts
    1,956
    Quote Originally Posted by yacpatty View Post
    Hi Everyone....11 days from surgery. I need some support here. I received a call from the doctor's nurse yesterday. The doctor has not decided on how many levels he is going to fuse until he sees how much bone and my synovial cyst could be attached to the dura....the dura is the outer covering of the spinal canal....if the dura tears at the point where the L4-L5 needs decompressed or where the cyst needs removed, the doctor will suture it. The more places the dura tears, the higher risk of losing spinal canal fluid. I was hoping I would be fused from L2-sacrum but now it depends on what he finds when going in. Of course, I told the doctor's nurse that I will certainly depend totally on his expertise to make those decisions even though I was hoping I could be fused to the sacrum....a once and done deal. Do any of you, especially Linda and TitaniumEd, have any experience or information regarding the dura and have any of you had experience with your doctor having to suture the dura? I am a little worried about this even though I have one of the best doctors around and then worried if he only fuses L4-L5, I will still have problems at L2-L3, L3-L4 and L5-S1. Ed, did you have severe lateral stenosis in the lumbar area. The nurse is saying when severe lateral stenosis is involved, there is a much better chance some of the bone is attached to the dura. Thanks everyone for your input.....11 days to go!!!!

    Patty
    I had a tear, I can't remember what level it was. They repaired it, and I had to lay flat for 24 hours post surgery. I was fine, there were no further complications.
    __________________________________________
    Debbe - 50 yrs old

    Milwalkee Brace 1976 - 79
    Told by Dr. my curve would never progress

    Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
    Pre-Surgury Thorasic: 66 degrees
    Pre-Surgery Lumbar: 66 degrees

    Post-Surgery Thorasic: 34 degrees
    Post-Surgery Lumbar: 22 degrees

  7. #7
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    766
    You are almost there and it will be very busy the next few days. Eat well and get your rest as your body will be going through a lot in just a few days. I did answer your PM. I aiso had a Cec surgery and just passed the 4 year mark. It is hard not to celebrate each year. Listen to Ed-- he has a wonderful take on this accomplishment! I will pray for the best for you. I think I noticed you are from PA,I was born near Pittsburg, but live in Illinois now.

  8. #8
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,527
    I agree with Ed in that you need to worry about the things that you can control and the rest to leave to the competent hands of your doctor. Our levels of fusion are similar, so I look forward to hearing your progress.
    You will do fine whatever happens.
    Hugs
    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  9. #9
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,557
    Patty

    Your probably travelling or have just gotten there and just wanted to wish you all the best for Tuesday.

    Our thoughts are with you.

    Ed
    49 yr old male, now 59, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  10. #10
    Join Date
    Apr 2012
    Location
    Harrisburg, Pa.
    Posts
    85

    Dural Deficiency

    Hi Ed,

    Thanks so much for your well wishes. Surgery starts at 7:30 am St. Louis time. Ed, happy birthday on the 11th. Enjoy every day of your good health. I have had so much radiation from x-rays and CT scans, I think I just might be glowing in the dark. Ha!!!!! I will post on the forum as soon as I am feeling well enough.

    Patty
    1963 Fusion T4-L2 for congenital scoliosis. It was a bone graft and not instrumentation
    1989 to Present....Have had chronic pain. MRI's show severe neural foraminal stenosis L2-S1, rotational scoliosis lumbar spine over 40 degrees, compression of nerve roots L5-S1, Broad Based Herniations L4-L5, L5-S
    Surgery scheduled with Dr. Bridwell on December 11, 2012
    December 11, 2012 Had surgery with Dr. Bridwell. He fused L4-L5 with rods and screws.

  11. #11
    Join Date
    Feb 2010
    Location
    Ohio
    Posts
    200
    Patty,
    I'll be thinking of you tomorrow. You are in good hands! It will be fine. You probably already have your central line, so that part is over. Now you just go to sleep and let Dr. Bridwell and team do their work.
    I'll be watching for your post surgery posts!
    Hugs,
    Kathy
    46 yrs at surgery, now 50
    71 degree thoracolumbar curve corrected to 34 degrees
    8/2/2010 surgery with Dr. Lenke

    posterior T9 to sacrum with pelvic fixation

    4 osteotomies and 1 cage
    http://s1066.photobucket.com/albums/...athK_08022010/

  12. #12
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,527
    Thinking of you and hoping that all is going well.
    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  13. #13
    Join Date
    Jan 2009
    Location
    Ames, Iowa
    Posts
    1,250
    Patty--
    Best of luck to you. Lots of people cheering & praying you on to a successful surgery and recovery! Janet
    Janet

    61 years old--57 for surgery

    Diagnosed in 1965 at age of 13--no brace
    Thoracic Curve: 96 degrees to 35 degrees
    Lumbar Curve: 63 degrees to 5 degrees
    Surgery with Dr. Lenke in St. Louis--March 30, 2009
    T-2 to Pelvis, and hopefully all posterior procedure.

    All was posterior along with 2 cages and 6 osteotomies.

  14. #14
    Join Date
    May 2012
    Location
    El Centro, CA & Baja California, Mexico
    Posts
    193

    Are you OK? it will pass eventually (suppositories)

    I was trying to find you, Yacpatty .... I had surgery and left the hospital on Dec 9th.

    I had a dural tear and it was expected. Dr Bridwell had the Neurologist dept in the OR just to patch it if and when it happened. It happened and all is good only that it required 72 extra hours of bed rest which complicated the otherwise quicker recovery. With the extra time down, the intestines did not wake up sooner thus massive amount of gas invaded my front tummy (as opposed to my back tummy). No pain was felt on the back but the front was having a Rosemary's baby travelling up and down. My tummy was so bloated and one can see the journey of the gas starting from one end to the other.

    Dr Bridwell asked if by chance I might be pregnant as I was so distented. Husband said: Not mine! I said: the only person I have been close is with you Dr Bridwell and it absolutely feels like 3 (three) little white hair short BOYS wearing medical gowns and stestoscope running wild in my stomach to see how much havoc they can make.

    He laughed! And, he is absoulutely adorable and caring. All the nurses are terrified of him to an extend that I had to argue with them that I am not (they might) but he is my doctor, i.e. I hired him. There is nothing more frustrating than to have a nurse argue with you about their believes. It gains nothing but more stress.

    I was released and moved over to the Metro Lofts until Jan 19 making sure all is right before returning to Mexico.

    I never exercised much before but now I am very motivated to walk the halls because of the constipation, the knees pain, the leg circulation not to mention pain in both hips and butt.

    Moving forward my friend.... Call or contact me if you like 650 862 6708 (very busy in bed switching between a kindle, a book, or playing a game. Very boring. My husband works in the living room and has been really helpful.

    Getting up and down in bed is easy. Turning is difficult....

    gardenia
    Gardenia
    Baja California, Mexico & El Centro, Ca
    pre-surgery 75 and 89 - post ?
    Dr. Bridwell Nov 27, 2012 @Barnes Jewish @62yrs
    T11 to Sacrum Dural leak at L2 & L3 ccmail4g@gmail.com

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