Unintended durotomy during degenerative lumbar spine surgery : incidence and management

الملخص EN

Background : Unintended durotomy is an infrequent but well-recognized Complication during degenerative lumbar spine surgery.

The current literatures report a wide variation in incidence of durotomy during degenerative lumbar spine surgery.

Objective : To assess the incidence, treatment, clinical consequence, complications of unintended durotomy during degenerative lumbar spine surgery, and the results of 2-24 months clinical follow-up.

Patients and Methods : A prospective study was conducted on 264 patients who underwent degenerative lumbar spine surgery performed in Al-Sheikh Zayed Hospital and private nursing home hospital- medical city in Baghdad from January 2011 to June 2012.

Patients managed by spine fixation were excluded from this study.

Results : The incidence of unintended durotomy during spine surgery was 8.33 % (22 of 264 cases).

The incidence varies according to the type of surgery being performed (6.66 % in primary discectomy, 12.5 % in decompressive laminectomy and 21.73 % in revision surgery).

Unintended durotomy was more common in revision surgery compared with primary surgery (21.73 % vs 7.05 % ; p < .001), and it was significantly more common among elderly patients (17.39 % in patients > 60 years old ; p = .006).

Most of the durotomies were managed by primary repair.

A mean follow-up of 6 months showed good long-term clinical results.

Conclusions : All unintended durotomies must be repaired primarily.

Durotomies that were immediately recognized and treated did not lead to any significant sequelae at a mean follow-up of 6 months.