Incidental durotomy in lumbar spine surgery: incidence and management

Eur Spine J. 2005 Apr;14(3):287-90. doi: 10.1007/s00586-004-0821-2. Epub 2004 Nov 17.

Abstract

There is increasing awareness of the need to inform patients of common complications that occur during surgical procedures. During lumbar spine surgery, incidental tear of the dural sac and subsequent cerebrospinal fluid leak is possibly the most frequently occurring complication. There is no consensus in the literature about the rate of dural tears in spine surgery. We have undertaken this study to evaluate the incidence of dural tears among spine surgeons in the United Kingdom for commonly performed spinal procedures. Prospective data was gathered for 1,549 cases across 14 institutions in the United Kingdom. The results give us a baseline rate for the incidence of dural tears. The rate was 3.5% for primary discectomy, 8.5% for spinal stenosis surgery and 13.2% for revision discectomy. There was a wide variation in the actual and estimated rates of dural tears among the spine surgeons. The results confirm that prospective data collection by spine surgeons is the most efficient and accurate way to assess complication rates for spinal surgery.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Diskectomy / adverse effects*
  • Diskectomy / methods
  • Dura Mater / injuries*
  • Female
  • Humans
  • Incidence
  • Intraoperative Complications / diagnosis*
  • Intraoperative Complications / epidemiology*
  • Male
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / methods
  • Prospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Spinal Stenosis / pathology
  • Spinal Stenosis / surgery*
  • Surveys and Questionnaires
  • United Kingdom / epidemiology