BACKGROUND: Incidental durotomy is a familiar encounter during surgery for lumbar spinal stenosis. The impact of durotomy on long-term outcomes remains a matter of debate. OBJECTIVE: To determine the impact of durotomy on the long-term outcomes of patients in the Spine Patient Outcomes Research Trial (SPORT). METHODS: The SPORT cohort participants with a confirmed diagnosis of spinal stenosis, without associated spondylolisthesis, undergoing standard, first-time, open decompressive laminectomy, with or without fusion, were followed up from baseline at 6 weeks, and 3, 6, and 12 months and yearly thereafter at 13 spine clinics in 11 US states. Patient data from this prospectively gathered database were reviewed. As of May 2009, the mean follow-up among all analyzed patients was 43.8 months. RESULTS: Four hundred nine patients underwent first-time open laminectomy with or without fusion. Thirty-seven of these patients (9%) had an incidental durotomy. No significant differences were observed with or without durotomy in age; sex; race; body mass index; the prevalence of smoking, diabetes mellitus, and hypertension; decompression level; number of levels decompressed; or whether an additional fusion was performed. The durotomy group had significantly increased operative duration, operative blood loss, and inpatient stay. There were, however, no differences in incidence of nerve root injury, mortality, additional surgeries, or primary outcomes (Short Form-36 Bodily Pain or Physical Function scores or Oswestry Disability Index) at yearly follow-ups to 4 years. CONCLUSIONS: Incidental durotomy during first-time lumbar laminectomy for spinal stenosis did not impact long-term outcomes in affected patients.
BACKGROUND: Incidental durotomy is a familiar encounter during surgery for lumbar spinal stenosis. The impact of durotomy on long-term outcomes remains a matter of debate. OBJECTIVE: To determine the impact of durotomy on the long-term outcomes of patients in the Spine Patient Outcomes Research Trial (SPORT). METHODS: The SPORT cohort participants with a confirmed diagnosis of spinal stenosis, without associated spondylolisthesis, undergoing standard, first-time, open decompressive laminectomy, with or without fusion, were followed up from baseline at 6 weeks, and 3, 6, and 12 months and yearly thereafter at 13 spine clinics in 11 US states. Patient data from this prospectively gathered database were reviewed. As of May 2009, the mean follow-up among all analyzed patients was 43.8 months. RESULTS: Four hundred nine patients underwent first-time open laminectomy with or without fusion. Thirty-seven of these patients (9%) had an incidental durotomy. No significant differences were observed with or without durotomy in age; sex; race; body mass index; the prevalence of smoking, diabetes mellitus, and hypertension; decompression level; number of levels decompressed; or whether an additional fusion was performed. The durotomy group had significantly increased operative duration, operative blood loss, and inpatient stay. There were, however, no differences in incidence of nerve root injury, mortality, additional surgeries, or primary outcomes (Short Form-36 Bodily Pain or Physical Function scores or Oswestry Disability Index) at yearly follow-ups to 4 years. CONCLUSIONS: Incidental durotomy during first-time lumbar laminectomy for spinal stenosis did not impact long-term outcomes in affected patients.
Authors: James N Weinstein; Jon D Lurie; Tor D Tosteson; Jonathan S Skinner; Brett Hanscom; Anna N A Tosteson; Harry Herkowitz; Jeffrey Fischgrund; Frank P Cammisa; Todd Albert; Richard A Deyo Journal: JAMA Date: 2006-11-22 Impact factor: 56.272
Authors: Mustafa H Khan; Jeffery Rihn; Garen Steele; Rick Davis; William F Donaldson; James D Kang; Joon Y Lee Journal: Spine (Phila Pa 1976) Date: 2006-10-15 Impact factor: 3.468
Authors: Y Raja Rampersaud; Eduardo R P Moro; Mary Ann Neary; Kevin White; Stephen J Lewis; Eric M Massicotte; Michael G Fehlings Journal: Spine (Phila Pa 1976) Date: 2006-06-01 Impact factor: 3.468
Authors: Brian T Jankowitz; Dave S Atteberry; Peter C Gerszten; Patricia Karausky; Boyle C Cheng; Ryan Faught; William C Welch Journal: Eur Spine J Date: 2009-03-13 Impact factor: 3.134
Authors: James N Weinstein; Jon D Lurie; Tor D Tosteson; Anna N A Tosteson; Emily A Blood; William A Abdu; Harry Herkowitz; Alan Hilibrand; Todd Albert; Jeffrey Fischgrund Journal: Spine (Phila Pa 1976) Date: 2008-12-01 Impact factor: 3.468
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
Authors: Nils H Ulrich; Jakob M Burgstaller; Florian Brunner; François Porchet; Mazda Farshad; Giuseppe Pichierri; Johann Steurer; Ulrike Held Journal: BMC Musculoskelet Disord Date: 2016-04-18 Impact factor: 2.362
Authors: Sravisht Iyer; Eric O Klineberg; Lukas P Zebala; Michael P Kelly; Robert A Hart; Munish C Gupta; D Kojo Hamilton; Gregory M Mundis; Daniel Sciubba; Christopher P Ames; Justin S Smith; Virginie Lafage; Douglas Burton; Han Jo Kim Journal: Global Spine J Date: 2017-07-20