I am helping my aging mother who is going to have spine surgery. In the course of getting her ready, they must have gone over the potential side effects (if something goes wrong) a half dozen times. They especially wanted her to know about how there could be a tear to the lining of her spine and leakage of fluid. Do they think she can’t understand just because she’s older? Her hearing and mental capacities are perfectly fine and it seems obvious to me that she is “with it” enough to get it the first time.

Complications of surgery can be a serious thing. Many people preparing for surgery are nervous and don’t always process what they are being told. Having a friend or family member present during the preoperative instructions is always a good idea.

In the case of a spinal surgery, the anatomy is complex and the risk of complications such as a dural tear are increased. Problems with spinal surgery are common even for the most experienced surgeons.

The dura is a protective lining around the spinal cord and brain. It has three layers to help provide a thin but strong structure. It provides an airtight, leak proof outer layer to contain the cerebrospinal fluid (CSF). The CSF cushions and bathes the brain and spinal cord in a protective plasma fluid.

Any time surgery is done on the spine, there is a risk that the dura will get torn or damaged. And if all three layers are torn, then the cerebrospinal fluid can leak out. If that happens, watch out! Major headache, nausea, and light sensitivity can develop after surgery.

Because dural tears are common during spinal surgery, the surgeon usually makes sure the patient understands the risk and the side effects of this complication. Patients are fully informed up front (before surgery) about the risk of a dural tear and the fact that if a dural tear occurs, a second surgery to repair the tear may be needed.

Surgeons do everything they can to prevent any and all complications. For example, they assess the patient ahead of time for risk factors that might help them prevent dural tears from occurring. Patients who understand the potential problems are better able to deal with them should they occur.