Cauda equina syndrome after use of dural sealant in revision lumbar decompression surgery.

Objective We report a case of cauda equina syndrome related to the use of fibrin glue dural sealant "TISSEEL". Background Incidental durotomy (ID) is not uncommon in revision spinal surgery. Augmentation of the dural repair after primary closure is gaining popularity. The use of dural sealants is not risk-free. Method A 65-year old man who underwent revision lumbar decompression surgery developed postoperative cauda equina syndrome. He had urinary retention, bilateral leg pain and perianal numbness on the third postoperative day. We believe this complication was related to the use of fibrin glue to manage an ID. Result After the urgent surgical removal of the fibrin glue patch, the patient fully recovered with no residual neurological deficit. Conclusion Cauda equina syndrome development is a potential complication after the use of fibrin glue to augment intraoperative ID. Surgeons should be aware of this potential risk so it can be managed in a timely fashion.