Owoicho Adogwa1, Mary I Huang2, Paul M Thompson2, Timothy Darlington2, Joseph S Cheng3, Ziya L Gokaslan4, Oren N Gottfried2, Carlos A Bagley2, Greg D Anderson5, Robert E Isaacs2. 1. Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Box 3807, 1000 Trent Drive, Room 4517 Busse Bldg, Durham, NC 27710, USA. Electronic address: owoicho.adogwa@gmail.com. 2. Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Box 3807, 1000 Trent Drive, Room 4517 Busse Bldg, Durham, NC 27710, USA. 3. Department of Neurosurgery, Vanderbilt University Medical Center, 719 Thompson Lane, Suite 23108, Nashville, TN 37204, USA. 4. Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe St, Meyer 7-109, Baltimore, MD 21287, USA. 5. Department of Orthopaedic and Neurological Surgery, Rothman Institute, Thomas Jefferson University Hospitals, 170 North Henderson Rd, King of Prussia, PA 19406, USA.
Abstract
BACKGROUND: Incidental durotomies occur in up to 17% of spinal operations. Controversy exists regarding the short- and long-term consequences of durotomies. PURPOSE: The primary aim of this study was to assess the effect of incidental durotomies on the immediate postoperative complications and patient-reported outcome measures. STUDY DESIGN: Prospective study. PATIENT SAMPLE: A total of 1,741 patients undergoing index lumbar spine fusion were selected from a multi-institutional prospective data registry. OUTCOME MEASURES: Patient-reported outcome measures used in this study included back pain (BP-Visual Analog Scale), leg pain (LP-Visual Analog Scale), and Oswestry Disability Index. METHODS: A total of 1,741 patients were selected from a multi-institutional prospective data registry, who underwent primary lumbar fusion for low back pain and/or radiculopathy between January 2003 and December 2010. We collected and analyzed data on patient demographics, postoperative complications, back pain, leg pain, and functional disability over 2 years, with risk-adjusted propensity score modeling. RESULTS: Incidental durotomies occurred in 70 patients (4%). Compared with the control group (n=1,671), there was no significant difference in postoperative infection (p=.32), need for reoperation (p=.85), or symptomatic neurologic damage (p=.66). At 1- and 2-year follow-up, there was no difference in patient-reported outcomes of back pain (BP-Visual Analog Scale), leg pain (LP-Visual Analog Scale), or functional disability (Oswestry Disability Index) (p>.3), with results remaining consistent in the propensity-matched cohort analysis (p>.4). CONCLUSION: Within the context of an on-going debate on the consequences of incidental durotomy, we found no difference in neurologic symptoms, infection, reoperation, back pain, leg pain, or functional disability over a 2-year follow-up period. Published by Elsevier Inc.
BACKGROUND: Incidental durotomies occur in up to 17% of spinal operations. Controversy exists regarding the short- and long-term consequences of durotomies. PURPOSE: The primary aim of this study was to assess the effect of incidental durotomies on the immediate postoperative complications and patient-reported outcome measures. STUDY DESIGN: Prospective study. PATIENT SAMPLE: A total of 1,741 patients undergoing index lumbar spine fusion were selected from a multi-institutional prospective data registry. OUTCOME MEASURES: Patient-reported outcome measures used in this study included back pain (BP-Visual Analog Scale), leg pain (LP-Visual Analog Scale), and Oswestry Disability Index. METHODS: A total of 1,741 patients were selected from a multi-institutional prospective data registry, who underwent primary lumbar fusion for low back pain and/or radiculopathy between January 2003 and December 2010. We collected and analyzed data on patient demographics, postoperative complications, back pain, leg pain, and functional disability over 2 years, with risk-adjusted propensity score modeling. RESULTS: Incidental durotomies occurred in 70 patients (4%). Compared with the control group (n=1,671), there was no significant difference in postoperative infection (p=.32), need for reoperation (p=.85), or symptomatic neurologic damage (p=.66). At 1- and 2-year follow-up, there was no difference in patient-reported outcomes of back pain (BP-Visual Analog Scale), leg pain (LP-Visual Analog Scale), or functional disability (Oswestry Disability Index) (p>.3), with results remaining consistent in the propensity-matched cohort analysis (p>.4). CONCLUSION: Within the context of an on-going debate on the consequences of incidental durotomy, we found no difference in neurologic symptoms, infection, reoperation, back pain, leg pain, or functional disability over a 2-year follow-up period. Published by Elsevier Inc.
Authors: Miranda L van Hooff; Wilco C H Jacobs; Paul C Willems; Michel W J M Wouters; Marinus de Kleuver; Wilco C Peul; Raymond W J G Ostelo; Peter Fritzell Journal: Acta Orthop Date: 2015 Impact factor: 3.717
Authors: Isaac O Karikari; Keith H Bridwell; Aladine A Elsamadicy; Lawrence G Lenke; Patrick Sugrue; David Bumpass; Azeem Ahmad; Jeffrey Gum Journal: Global Spine J Date: 2017-10-25