What does the dural sac do?
The thecal sac or dural sac is the membranous sheath (theca) or tube of dura mater that surrounds the spinal cord and the cauda equina. The thecal sac contains the cerebrospinal fluid which provides nutrients and buoyancy to the spinal cord.
At which level does the dural sac end?
In an adult the dural sac terminates caudally at S2. The termination of the adult spinal cord, on the other hand, is at L1-2 and is called the conus medullaris. In newborns the dura mater ends at S3, and the conus medullaris at L3. This changes over the first year of life.
Where does the dural sac end in children?
By birth the sac ends at S3 or S4, with the conus medullaris terminating at the L3 or L4 level. It is not until approximately 1 year of age that anatomic relationships resemble that of the adult. It is thus possible to enter the dural sac during caudal anesthesia in very young infants.
Where does dural sac begin?
Here at the base of the skull, the dural sac passes through the foramen magnum, becoming continuous with the layer of dura that surrounds the brain. At the bottom end, within the vertebral canal of the sacrum, the dural sac tapers down to a point, at the level of the second sacral segment.
What is a dural sac tear?
An accidental dural tear is a potential complication of spine surgery. This occurs when the thin covering over the spinal cord (called meninges) is nicked by the surgical instrument.
How serious is a dural tear?
Cerebrospinal fluid (CSF) leakage following dural tears can pose potentially serious problems such as CSF fistula formation, pseudomeningocele, meningitis, arachnoiditis and epidural abscess[1,3,10,12,15].
What does the dural sac contain?
The thecal sac or dural sac is the membranous sheath of dura mater that surrounds the spinal cord and the cauda equina. The thecal sac contains the cerebrospinal fluid in which the spinal cord ‘floats’.
What is the difference between dura mater and dural sac?
Cranial dura mater has two layers called lamellae, a superficial layer (also called the periosteal layer), which serves as the skull’s inner periosteum, called the endocranium and a deep layer called the meningeal layer. When it covers the spinal cord it is known as the dural sac or thecal sac.
At which level does the spinal cord end in newborn?
L2/L3
In the newborn/infant group the spinal cord terminated most frequently at the level of L2/L3 (16%). In the childhood stage, the spinal cord terminated at the levels of T12/L1 and the lower third of L1 (21%). In the adolescent population, it was most often found at the level of the middle third of L1 and L1/L2 (19%).
Is a dural tear serious?
How do you fix dura?
Patch repair of injured dura using polyglactin and fibrin glue is a useful technique for preventing leakage of cerebrospinal fluid in microendoscopic spinal surgery without requiring an open operation and can be used in any minimally-invasive surgery, including microendoscopic surgery.
How long does it take for a dural tear to heal?
The duration of follow-up ranged from two to eight years (average, 4.3 years). Postoperative management consisted of closed suction wound drainage for an average of 2.1 days and bed rest for an average of 2.9 days.
Is the dural sac part of the spinal cord?
Where does dura end?
The outer membrane surrounding the spinal cord is the dura mater (from Latin, meaning durable mother). The dura, made of a dense fibrous material, forms the dural sac, which surrounds the spinal cord and cauda equina (to be discussed later) and terminates at the level of the second sacral vertebra.
How fast does dura heal?
The repair site can take four to six weeks to heal completely.
What is dura in surgery?
The dura is a thin layer of tissue that covers and protects the spinal cord. It lies in between the spine (the bone) and the spinal cord (nerve tissue). Durotomy, which is an incision in the dura, can be a planned part of the surgical technique.
What is the function of the dural sac?
Definition. Laterally, it follows the spinal nerve roots out to about the level of the intervertebral foramina, where it blends with the epineurium of the roots. The dural sac and closely adherent arachnoid mater on its inner surface, are a barrier to drug migration into and out of the cerebrospinal fluid during epidural anesthesia.
What is the caudal extent of the dural sac?
Dural sac: Caudal extent. Definition. In an adult the dural sac terminates caudally at S2. The termination of the adult spinal cord, on the other hand, is at L1-2 and is called the conus medullaris. In newborns the dura mater ends at S3, and the conus medullaris at L3. This changes over the first year of life. Spinal Anatomy (Adults) Dural Sac: S2.
Is it safe to enter the dural sac during caudal anesthesia?
It is thus possible to enter the dural sac during caudal anesthesia in very young infants. If spinal anesthesia is used in this population, a low approach to entering the dural sac is warranted to avoid the cord. Barash, PG 2009.
What is the prevalence of dural sinus thrombosis in the newborn period?
Dural sinus thrombosis in the newborn period has been infrequently documented and its clinical presentation remains obscure. Seventeen patients, all of whom were born at term with dural sinus thrombosis diagnosed in the neonatal period, were retrospectively identified and reviewed.