Literature DB >> 22342249

Risk factors for unintended durotomy during spine surgery: a multivariate analysis.

Geoff A Baker1, Amy M Cizik, Richard J Bransford, Carlo Bellabarba, Mark A Konodi, Jens R Chapman, Michael J Lee.   

Abstract

BACKGROUND CONTEXT: Incidental durotomy during spine surgery is a common occurrence, with a reported incidence ranging from 3% to 16%. Risk factors identified by prior studies include age, type of procedure, revision surgery, ossification of the posterior longitudinal ligament, gender, osteoporosis, and arthritis. However, these studies are largely univariate analyses using retrospectively recorded data.
PURPOSE: To identify and quantify statistically significant risk factors for inadvertent durotomy during spine surgery. STUDY
DESIGN: Multivariate analysis of prospectively collected registry data. The University of Washington Spine End Results Registry 2003 and 2004 is a compilation of prospectively collected detailed data on 1,745 patients who underwent spine surgery during 2003 to 2004. PATIENT SAMPLE: One thousand seven hundred forty-five patients underwent spine surgery from 2003 to 2004 at our two institutions. OUTCOME MEASURES: Cardiac, pulmonary, gastrointestinal, neurologic, renal, and urologic complications defined a priori data collection.
METHODS: Using these data, univariate and multivariate statistical analyses were performed to identify and quantify risk factors for incidental durotomy during spine surgery. Relative risk (RR) values with valid confidence intervals and p values were determined using these data.
RESULTS: Our multivariate analysis demonstrated that age, lumbar surgery, revision surgery, and elevated surgical invasiveness are significant risk factors for unintended durotomy. Of these, revision surgery was the strongest risk factor for dural tear (RR, 2.21). Diabetes was a significant risk factor in the univariate analysis but not in the multivariate analysis.
CONCLUSIONS: Revision surgery, age, lumbar surgery, degenerative disease, and elevated surgical invasiveness are significant risk factors for unintended durotomy during spine surgery. These data can be useful to surgeons and patients when considering surgical treatment. Copyright Â
© 2012 Elsevier Inc. All rights reserved.

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Year:  2012        PMID: 22342249      PMCID: PMC3299921          DOI: 10.1016/j.spinee.2012.01.012

Source DB:  PubMed          Journal:  Spine J        ISSN: 1529-9430            Impact factor:   4.166


  14 in total

1.  Incidental durotomy in spine surgery.

Authors:  F P Cammisa; F P Girardi; P K Sangani; H K Parvataneni; S Cadag; H S Sandhu
Journal:  Spine (Phila Pa 1976)       Date:  2000-10-15       Impact factor: 3.468

2.  Incidental durotomy in lumbar spine surgery: incidence and management.

Authors:  Suhayl I Tafazal; Philip J Sell
Journal:  Eur Spine J       Date:  2004-11-17       Impact factor: 3.134

3.  The frequency and etiology of intraoperative dural tears in 110 predominantly geriatric patients undergoing multilevel laminectomy with noninstrumented fusions.

Authors:  Nancy E Epstein
Journal:  J Spinal Disord Tech       Date:  2007-07

4.  Development of an index to characterize the "invasiveness" of spine surgery: validation by comparison to blood loss and operative time.

Authors:  Sohail K Mirza; Richard A Deyo; Patrick J Heagerty; Mark A Konodi; Lorri A Lee; Judith A Turner; Robert Goodkin
Journal:  Spine (Phila Pa 1976)       Date:  2008-11-15       Impact factor: 3.468

5.  Higher risk of dural tears and recurrent herniation with lumbar micro-endoscopic discectomy.

Authors:  Marco Teli; Alessio Lovi; Marco Brayda-Bruno; Antonino Zagra; Andrea Corriero; Fabrizio Giudici; Leone Minoia
Journal:  Eur Spine J       Date:  2010-02-03       Impact factor: 3.134

6.  Intra- and postoperative complications in lumbar disc surgery.

Authors:  D Stolke; W P Sollmann; V Seifert
Journal:  Spine (Phila Pa 1976)       Date:  1989-01       Impact factor: 3.468

7.  Predictive factors for dural tear and cerebrospinal fluid leakage in patients undergoing lumbar surgery.

Authors:  Anthony H Sin; Gloria Caldito; Donald Smith; Mahmoud Rashidi; Brian Willis; Anil Nanda
Journal:  J Neurosurg Spine       Date:  2006-09

8.  Cerebrospinal fluid leaks following cervical spine surgery.

Authors:  David Hannallah; Joon Lee; Mustafa Khan; William F Donaldson; James D Kang
Journal:  J Bone Joint Surg Am       Date:  2008-05       Impact factor: 5.284

9.  Dural tears secondary to operations on the lumbar spine. Management and results after a two-year-minimum follow-up of eighty-eight patients.

Authors:  J C Wang; H H Bohlman; K D Riew
Journal:  J Bone Joint Surg Am       Date:  1998-12       Impact factor: 5.284

10.  Towards standardized measurement of adverse events in spine surgery: conceptual model and pilot evaluation.

Authors:  Sohail K Mirza; Richard A Deyo; Patrick J Heagerty; Judith A Turner; Lorri A Lee; Robert Goodkin
Journal:  BMC Musculoskelet Disord       Date:  2006-06-20       Impact factor: 2.362

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  38 in total

1.  Remote Cerebellar Hemorrhage Complicating Unintended Durotomy in Lumbar Spine Surgery.

Authors:  Yizhar Floman; Michael A Millgram; Ely Ashkenazi; Nahshon Rand
Journal:  Int J Spine Surg       Date:  2015-07-14

2.  Incidental durotomy in decompression for lumbar spinal stenosis: incidence, risk factors and effect on outcomes in the Spine Tango registry.

Authors:  Christian Herren; Rolf Sobottke; Anne F Mannion; Thomas Zweig; Everard Munting; Philippe Otten; Tim Pigott; Jan Siewe; Emin Aghayev
Journal:  Eur Spine J       Date:  2017-06-20       Impact factor: 3.134

Review 3.  Spinal osteotomy in the presence of massive lumbar epidural scarring.

Authors:  Vincent Arlet
Journal:  Eur Spine J       Date:  2014-11-27       Impact factor: 3.134

4.  Incidental durotomy in spine surgery: first aid in ten steps.

Authors:  Luca Papavero; Nils Engler; Ralph Kothe
Journal:  Eur Spine J       Date:  2015-03-04       Impact factor: 3.134

5.  Do surgeon credentials affect the rate of incidental durotomy during spine surgery.

Authors:  N J Murray; A K Demetriades; D Rolton; C Nnadi
Journal:  Eur Spine J       Date:  2014-03-13       Impact factor: 3.134

6.  Predictive factors for neurological deterioration after surgical decompression for thoracic ossified yellow ligament.

Authors:  Chris Yuk Kwan Tang; Jason Pui Yin Cheung; Dino Samartzis; Ka Hei Leung; Yat Wa Wong; Keith Dip Kei Luk; Kenneth Man Chee Cheung
Journal:  Eur Spine J       Date:  2017-04-03       Impact factor: 3.134

7.  Incidental dural tear in spine surgery: analysis of a nationwide database.

Authors:  Hiroyuki Yoshihara; Daisuke Yoneoka
Journal:  Eur Spine J       Date:  2013-11-09       Impact factor: 3.134

8.  Predicting medical complications after spine surgery: a validated model using a prospective surgical registry.

Authors:  Michael J Lee; Amy M Cizik; Deven Hamilton; Jens R Chapman
Journal:  Spine J       Date:  2013-11-13       Impact factor: 4.166

9.  The effect of incidental dural lesions on outcome after decompression surgery for lumbar spinal stenosis: results of a multi-center study with 800 patients.

Authors:  Ralph Kothe; M Quante; N Engler; F Heider; J Kneißl; S Pirchner; C Siepe
Journal:  Eur Spine J       Date:  2016-04-28       Impact factor: 3.134

10.  Communicating hydrocephalus, a long-term complication of dural tear during lumbar spine surgery.

Authors:  David T Endriga; John R Dimar; Leah Y Carreon
Journal:  Eur Spine J       Date:  2015-10-31       Impact factor: 3.134

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