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Peer-reviewedCC BY-NC-ND 4.0Journal of Neurosurgery: Case Lessons

Delayed incidental dural tears from subfascial drains after spine surgery: illustrative cases

  • Katherine W. Zerebiec1
  • Darien L. Love1
  • Katherine E. Callahan1
  • Thomas Khodadad1
  • Elizabeth E. Wicks1
  • Craig Methot1
  • Erik Werheim1
  • Raj Thakrar2
  • Chason Ziino3
  • Bruce I. Tranmer1
  • Ryan P. Jewell1
  1. 1Division of Neurosurgery, University of Vermont Medical Center, Burlington, Vermont
  2. 2Warren Alpert Medical School of Brown University, Providence, Rhode Island
  3. 3Department of Orthopaedics and Rehabilitation, University of Vermont Medical Center, Burlington, Vermont
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Abstract

BACKGROUND: Placement of a subfascial drain following open spine surgery is common practice to mitigate postoperative complications, including epidural hematoma, seroma formation, surgical site infection, and wound dehiscence. The authors present 3 cases in which subfascial Hemovac drains were associated with postoperative durotomy following otherwise uncomplicated lumbar surgeries.

OBSERVATIONS: Three patients who underwent single-level lumbar surgery requiring postoperative drain placement subsequently developed CSF leaks, presumed to be secondary to intracorporeal drain movement consistent with the Euler buckling theory.

LESSONS: In patients undergoing uncomplicated single-level lumbar spine surgery, consideration should be given to the use of a silicone Jackson-Pratt drain rather than a compression-resistant polyvinyl chloride Hemovac drain. In a small surgical bed, a shorter and more compliant drain may be sufficient, whereas a stiff drain may act as a trocar.

https://thejns.org/doi/10.3171/CASE2640

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Cite

BibTeXRIS
BibTeX
@article{zerebiec2026delayed,
  title = {{Delayed incidental dural tears from subfascial drains after spine surgery: illustrative cases}},
  author = {Katherine W. Zerebiec and Darien L. Love and Katherine E. Callahan and Thomas Khodadad and Elizabeth E. Wicks and Craig Methot and Erik Werheim and Raj Thakrar and Chason Ziino and Bruce I. Tranmer and Ryan P. Jewell},
  journal = {Journal of Neurosurgery: Case Lessons},
  year = {2026},
  month = oct,
  doi = {10.3171/case2640},
  url = {https://doi.org/10.3171/case2640},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Delayed incidental dural tears from subfascial drains after spine surgery: illustrative cases
AU  - Katherine W. Zerebiec
AU  - Darien L. Love
AU  - Katherine E. Callahan
AU  - Thomas Khodadad
AU  - Elizabeth E. Wicks
AU  - Craig Methot
AU  - Erik Werheim
AU  - Raj Thakrar
AU  - Chason Ziino
AU  - Bruce I. Tranmer
AU  - Ryan P. Jewell
PY  - 2026
DA  - 2026/10/26
JO  - Journal of Neurosurgery: Case Lessons
DO  - 10.3171/case2640
UR  - https://doi.org/10.3171/case2640
AB  - BACKGROUND: Placement of a subfascial drain following open spine surgery is common practice to mitigate postoperative complications, including epidural hematoma, seroma formation, surgical site infection, and wound dehiscence. The authors present 3 cases in which subfascial Hemovac drains were associated with postoperative durotomy following otherwise uncomplicated lumbar surgeries.  OBSERVATIONS: Three patients who underwent single-level lumbar surgery requiring postoperative drain placement subsequently developed CSF leaks, presumed to be secondary to intracorporeal drain movement consistent with the Euler buckling theory.  LESSONS: In patients undergoing uncomplicated single-level lumbar spine surgery, consideration should be given to the use of a silicone Jackson-Pratt drain rather than a compression-resistant polyvinyl chloride Hemovac drain. In a small surgical bed, a shorter and more compliant drain may be sufficient, whereas a stiff drain may act as a trocar.  https://thejns.org/doi/10.3171/CASE2640
SN  - 2694-1902
ER  -