Incidental Durotomy in Spine Surgery

Cammisa, Frank P.; Girardi, Federico P.; Sangani, Poorab K.; Parvataneni, Hari K.; Cadag, Stefan; Sandhu, Harvinder S.

doi:10.1097/00007632-200010150-00019

Cited by 360 publications

(298 citation statements)

References 8 publications

Supporting

Mentioning

267

Contrasting

Unclassified

Order By: Relevance

“…The risk increase varies between double and fivefold [5,9] and in the paper of Cammisa et al [3], 38% of those with dural lesions had been subjected to 1-6 procedures on the lumbar spine previously. It seems that the risk is higher for less experienced surgeons [15].…”

Section: Discussionmentioning

confidence: 98%

“…In a large series of spinal procedures [4], it was demonstrated that the morbidity was lower for younger patients and for disc herniation surgery. The risk factors for dural tear and the long-term outcome after such an event have been reported by several authors [1,3,13] but to our knowledge mainly in retrospective studies. In the large prospective SPORT study, an incidence of 4% is related [14].…”

Section: Introductionmentioning

confidence: 90%

“…In the large prospective SPORT study, an incidence of 4% is related [14]. Contrasting results concerning the effect of dural lesion on the long-term follow-up exist where several authors [3,6,10] did not report inferior outcome after this complication while in a recent pair matched study [8] the long-term outcome in lumbar disc herniation surgery was inferior in the group afflicted with an incidental durotomy.…”

Section: Introductionmentioning

confidence: 95%

See 2 more Smart Citations

Dural lesions in lumbar disc herniation surgery: incidence, risk factors, and outcome

2009

View full text Add to dashboard Cite

In lumbar disc herniation surgery, dural lesions seem to be the most common complication today. Studies on incidence of and outcome after a dural lesion are mainly based on retrospective studies. In a prospective study within the framework of the Swedish Spine Register, 4,173 patients operated on for lumbar disc herniation were evaluated using pre-and 1-year postoperative protocols and complication registration. Mean patient age was 41 (18-81) years and 53% of the patients were male. 93% of the operations were performed on the two lowermost lumbar levels. The incidence of dural lesions in the material was 2.7%. In patients with previous disc surgery, the incidence was doubled, 5%, a significant increase (P = 0.02). Patients with dural lesions preoperatively had more back pain and inferior scores in general health and role emotional domains of the SF-36. These factors, however, were because they had been operated on previously, not related to the dural lesion as such. The relative improvement after surgery was similar whether a dural lesion had occurred or not. It is concluded that a dural lesion is a technical complication which must be solved at the time of surgery but which does not bear any negative implications on the long-term outcome for the patient.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 95%

See 1 more Smart Citation

Dural lesions in lumbar disc herniation surgery: incidence, risk factors, and outcome

2009

View full text Add to dashboard Cite

show abstract

“…Instead, the focus of the paper is generally the (positive) surgical outcome of the described procedure, with complications being mentioned in a subordinate paragraph, in the knowledge that ''no complications'' would raise suspicion of biased reporting. The complications listed are usually directly associated with a specific treatment or technique, such as incidental dural tears in decompressive surgery [5,13]. In general, complications are assessed and documented by medical professionals.…”

Section: Discussionmentioning

confidence: 99%

“…Review of the hospital charts after a defined procedure is the methodology most commonly used [5,12,18] and, hence, incidents that can be measured or visualised are usually preferred. The accuracy of placement of pedicle screws [8], dural tears [4,5], and neurological deficit [12] are just a few examples in this category. However, these complications are not necessarily the only ones that concern the patients or influence their satisfaction with treatment/global outcome.…”

Section: Discussionmentioning

confidence: 99%

The patient’s perspective on complications after spine surgery

Grob

Mannion

2009

Eur Spine J

View full text Add to dashboard Cite

Recent years have witnessed a paradigm shift in relation to the assessment of outcome in spine surgery: multidimensional patient-centred questionnaires have superseded traditional surgeon-based ratings of outcome, and surgical registries have been developed to capitalise on the principle of ''strength in numbers.'' However, the assessment of complications has not enjoyed this same enlightened patient-centred approach. The present study investigated post-surgical complications from the patient's perspective. All German-speaking patients undergoing surgery within our Spine Center in 2005 were asked to complete the patient-orientated Core Measures Outcome Index of the SSE Spine Tango Spine Surgery Registry before and 12 months after surgery; the surgeon completed a Spine Tango surgery form. In the 12-month questionnaire, the patient was asked, ''did any complications arise as a consequence of your operation 1 year ago (e.g. problems with wound healing, paralysis, sensory disturbances, etc.)? If so, give details.'' Patients were also asked about their satisfaction with the operation and the global outcome of surgery. 1,035 patients were sent a 12-month questionnaire; 972 (94%) returned the completed questionnaire. 29% patients answered ''yes'' to the question about complications. The incidence of patient-rated complications was significantly associated with outcome/satisfaction (P \ 0.05), suggesting these complications were not trivial to the patient. The results indicate that, just like outcome, ''complications'' should be assessed from both the patient's and the surgeon's perspectives, not least to better understand the reasons accounting for dissatisfaction and a poor patient-rated outcome.

show abstract

Successful salvage surgery for failed transforaminal lumbosacral interbody fusion using the anterior transperitoneal approach

Hozumi

Orita

Inage

et al. 2016

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

Incidental Durotomy in Spine Surgery

Abstract: Incidental durotomy, if recognized and treated appropriately, does not lead to long-term sequelae.

Cited by 360 publications

References 8 publications

Dural lesions in lumbar disc herniation surgery: incidence, risk factors, and outcome

Dural lesions in lumbar disc herniation surgery: incidence, risk factors, and outcome

The patient’s perspective on complications after spine surgery

Successful salvage surgery for failed transforaminal lumbosacral interbody fusion using the anterior transperitoneal approach

Contact Info

Product

Resources

About