My 76 year old mother in law had endoscopic microdiscectomy for spinal stenosis yesterday and the doctor said there was small 4mm dural tear that may or may not need repairing. She is having a headache from this as well. He suggested bed rest and lots of caffeine. What are your thoughts on the tear healing on its own and about how long should it take to heal? Thanks in advance for your insight!
The problem with endoscopic microdisectomies is that tears cannot be repaired. A 4mm tear might heal on its own but can leave a pseudomeningeocele (a false pocket of fluid-CSF).
The best treatment is lying down for about three days. Do not get up as healing is disrupted when you stand up due to the pressure rise in the CSF in the spine.
If headaches continue, a new MRI would be helpful and then a procedure called a blood patch. This is where the injectionist withdraws about 20cc of blood out of a vein and injects this blood around (but not into) the dura in the epidural space.
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.