We reviewed the cases of five consecutive patients with tears of the
spinal dura with postoperative leaks of cerebrospinal fluid. Problems in
cluded the persistence of cerebrospinal-fluid fistulas in four patients and
a late symptomatic pseudomeningocele in one, all requiring reoperation and
meticulous closure of the dura. Dural tears should be repaired at the time
of the original operation either directly or utilizing a fascial graft or a
tissue-plug technique. When the leak is first noted in the postoperative
period, reoperation for repair of the dura is recommended.