PMC5227154_01
(a) Preoperative waveform images of nerve conduction velocity test in the first patient; (b) postoperative (3 months) waveform images showing improvements in the right peroneal nerve motor test and decrease in amplitude in the right sural nerve sensory test.
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fig3
Three months after the surgery, nerve conduction velocity study yielded an improvement in the right peroneal nerve motor but there was some decrease in the right sural sensory nerve compared to the preoperative evaluation (Figure 3).
PMC5227154_02
(a) Dorsal incidental durotomy with herniated nerve root (marked by root dissector). (b) Anchor suture to open the vent and reposing the herniated nerve root. (c) Watertight closure using simple interrupted 6-0 polypropylene.
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fig1
It was discovered later that the tear was at the dorsal region accompanied with herniated nerve root (Figure 1(a)).
Tissue handling and preservation technique. (a) Assessment of the herniated nerve root; (b) putting the suture anchor at the edge of the vent; (c) reposing the nerve root at the top of the vent using blunt instrument; (d) gentle traction at the anchor to swallow the herniated nerve root and continuous suture were performed; (e) using the blunt edge of the root dissector to give a gentle push for the remaining herniated nerve root; (f) continuous suture was performed to the cephalad part of the vent; (g) final result shows that all nerves were into dural sac and the tear was recovered.
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fig2
There are five general steps that should be taken into consideration (Figure 2).