Thoracolumbar Fascia Grafting for Total Rupture of DuraMater in Traumatic Spinal Cord Injury: Case Report

Abstract

The impairment of the spinal cord could induce a prolonged neurological deficit, which is caused by traumatic Spinal Cord Injury (tSCI). This condition should be immediately treated. Repairment by using the fascia component would be better for improving spinal cord metabolism. A 28-year-old male working as an oil gardener was admitted to the emergency unit with a main complaint of pain around his back after having penetration trauma by a sickle tool two hours before admission. Swelling near the affected area and tenderness while performing palpation. The halo sign was found positive, AP-Lateral X-ray of thoracic vertebrae shows intact trabecula. The patient diagnosed by tSCI with dural tear and duraplasty was performed using thoracolumbar fascia grafting. Duraplasty procedure by using fascia grafting is preferred for managing tSCI, especially for patients with incised wound. Fascia grafting that was planted on the injured site could induce cord metabolism and spinal outflow. Intra-spinal pressure cannot be decreased solely by bone decompression; injured lesions often produce oedema, which compresses the spinal canal. Duraplasty is necessary to improve the patient's Quality of Life (QoL). Adequate modalities by using fascia grafting procedure would be easier to achieve the best possible outcome.