Common surgical complications in degenerative spinal surgery

Papadakis, Michael

doi:10.5312/wjo.v4.i2.62

Cited by 29 publications

(13 citation statements)

References 64 publications

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“…The rates of durotomy, nerve root injury, and symptomatic pedicle screw breach were well within national standards. 20,21 Meta-Analysis Comparisons to Traditional 2-D-guided Placement Techniques Data from 10 independent previous studies were chosen for meta-analysis. [22][23][24][25][26][27][28][29][30][31] Each of these studies reported pedicle screw breach incidence and degree using postoperative CT imaging.…”

Section: Resultsmentioning

confidence: 99%

Improved Accuracy of Minimally Invasive Transpedicular Screw Placement in the Lumbar Spine With 3-Dimensional Stereotactic Image Guidance

Bourgeois

Faulkner

Bradley

et al. 2015

Journal of Spinal Disorders &Amp; Techniques

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Section: Resultsmentioning

confidence: 99%

Improved Accuracy of Minimally Invasive Transpedicular Screw Placement in the Lumbar Spine With 3-Dimensional Stereotactic Image Guidance

Bourgeois

Faulkner

Bradley

et al. 2015

Journal of Spinal Disorders &Amp; Techniques

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“…10,13,14 The reported incidence varies from 15.9% in revision surgery to 3.5% in primary lumbar discectomy. 10,14,15 We found that revision surgeries had an incidence of 12.9% as compared with first time surgery (5.53%). Prior surgeries cause dural adhesions, absence of normal tissues and can lead to the loss of landmarks during surgery hence increased incidences.…”

Section: Discussionmentioning

confidence: 85%

Predictive Factors of Inadvertent Durotomy in Lumbosacral Prolapsed Intervertebral Disc Surgeries: A Retrospective Review at a Tertiary Care Centre in India

et al. 2020

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Introduction: Inadvertent dural tear is an undesirable intraoperative complication of spine surgery, with a reported incidence range of 1.7% to 17%. The purpose of this study is to determine the predictive factors of inadvertent durotomies (ID) in lumbosacral prolapsed disc surgeries and suggest a scoring system for pre-operative assessment of these predictors. Methods and Materials: This is a retrospective observational study done in 230 patients operated for prolapsed lumbar intervertebral discs, between January 2010 to November 2012. The inadvertent dural tears were grouped as unrecognised, simple and complicated. Data were collected regarding diagnosis, comorbidities, surgical procedure, operating surgeon, prior spine surgeries, type of ID and complications. Results: Of the 230 patients, ID was seen in 6.5 % (15 patients). Higher incidences were noted in elderly (33.3%) and obese (7.6%). Bone nibbler and Kerrison’s rongeur were the most common tools associated. Redo surgeries have a significant higher incidence (12.9%) as compared to the first surgery (5.53%). Conclusions: The risk of ID in prolapsed lumbar intervertebral disc surgeries is high in presence of bony and ligamentous canal stenosis, instrument handling, and in smaller size of incisions. Additionally, elderly age of patients, obesity and surgeon fatigue appears to be a major determinant. Conscious effort to prevent this complication during surgery by predicting risks pre-operatively using a scoring system can aid in preventing ID.

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“…16 The reported incidence varies from 15.9% in revision surgery to 3.5% in primary lumbar discectomy. 1,14 We found that revision procedures have a significant increased incidence of durotomy (11.9%) as compared with primary procedure (4.6%), this is due to the loss of anatomical landmarks and the postoperative adhesions which are common in revision cases. Strömqvis et al, 16 recommend to identify the dura in an unoperated area in the proximity of the previous operation and then carry on the dissection gently into the scarred and fibrotic area.…”

Section: Discussionmentioning

confidence: 91%

Predictive Factors for Dural Tear in Lumbar Spine Surgery

Abdelbaky¹,

Younes²,

Adawi³

2015

Egyptian Spine Journal

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Background Data: Incidental durotomy is an undesirable but significant complication of lumbar spine surgery Knowing about the predisposing factors for Incidental durotomy and meticulous surgical technique is important to avoid incidental dural tears. Purpose: The purpose of this study is to clarify the risk factors for ID in lumbar spine surgery and to assess the incidence, treatment and outcome of ID. Study Design: Retrospective descriptive clinical case study. Patients and Methods: A retrospective review was conducted on 450 patients who underwent surgical procedure for the treatment of degenerative lumbar spinal disease. Cases included in this study were operated for disc herniation, spinal stenosis, spondylolisthesis and post-laminectomy syndrome. We excluded Patients treated for spinal tumors, trauma, infections and deformity. Results: Incidental durotomies IDs were identified in 27 (6%) patients. The incidence of ID was much higher in revision procedures (11.9%) than in primary spinal procedures (4.6%). 18 (67%) of the 27 tears were caused by residents with the remaining 9 (33%) caused by the attending surgeon. Of the 27 dural tears 11 (40.7%) were caused by the Kerrison rongeur. All dural tears were repaired primarily. All patients achieved satisfactory outcomes other than 2 patients developed pseudomeningocele. Conclusion: Risk factors that can increase the likelihood of ID were older age, obesity, pervious spinal surgery and decreased experience of the surgeon. The most common instrument leading to ID is the Kerrison. Incidental durotomy can be treated successfully with primary watertight repair, subfascial drains and bed rest. (2015ESJ084)

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Common surgical complications in degenerative spinal surgery

Cited by 29 publications

References 64 publications

Improved Accuracy of Minimally Invasive Transpedicular Screw Placement in the Lumbar Spine With 3-Dimensional Stereotactic Image Guidance

Improved Accuracy of Minimally Invasive Transpedicular Screw Placement in the Lumbar Spine With 3-Dimensional Stereotactic Image Guidance

Predictive Factors of Inadvertent Durotomy in Lumbosacral Prolapsed Intervertebral Disc Surgeries: A Retrospective Review at a Tertiary Care Centre in India

Predictive Factors for Dural Tear in Lumbar Spine Surgery

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