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

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.