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

Herren, Christian; Sobottke, Rolf; Mannion, Anne F; Zweig, Thomas; Munting, Everard; Otten, Philippe; Pigott, Tim; Siewe, Jan; Aghayev, Emin; Spine Tango, Contributors (2017). Incidental durotomy in decompression for lumbar spinal stenosis: incidence, risk factors and effect on outcomes in the Spine Tango registry. European spine journal, 26(10), pp. 2483-2495. Springer 10.1007/s00586-017-5197-1

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PURPOSE The three aims of this Spine Tango registry study of patients undergoing decompression for spinal stenosis were to: report the rate of dural tear (DT) stratified by treatment centre; find factors associated with an increased likelihood of incurring a DT; and compare treatment outcomes in relation to DT (none vs. repaired vs. unrepaired DT). METHODS Multivariate logistic regression was used to assess the association between DT and patient and treatment characteristics. Patient-rated and surgical outcomes were compared in patients with no DT, repaired DT, and unrepaired DT, while adjusting for case-mix. RESULTS DT occurred in 328/3254 (10.1%) of included patients. The rate for all 29 contributing hospitals was within 95% confidence intervals of the average. The likelihood of DT increased by 2% per year of age, 1.78 times with previous spine surgery, 1.67 for a minimally/less invasive surgery, 1.58 times with laminectomy, and 1.40, and 2.12 times for BMI 31-35, and >35 in comparison with BMI 26-30, respectively. The majority of DTs (272/328; 82.9%) were repaired. Repairing the DT was associated with a longer duration of surgery (p < 0.001). More patients with repaired than with unrepaired DTs were satisfied with treatment, but the difference was not statistically significant. There was no association between DT and patient-reported outcomes. CONCLUSION The unadjusted rate of incidental DT during decompression for LSS was homogeneous across the participating centres and was associated with age, BMI, previous surgery at the same spinal level, minimally/less invasive surgery, and laminectomy. Non-repair of DTs had no negative association with treatment outcome; however, the unrepaired DTs may have been those that were smaller in size.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Aghayev, Emin

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0940-6719

Publisher:

Springer

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

16 Jan 2018 13:22

Last Modified:

22 Jan 2018 09:28

Publisher DOI:

10.1007/s00586-017-5197-1

PubMed ID:

28634709

Uncontrolled Keywords:

Decompression Durotomy Lumbar spinal stenosis Outcome Spine Tango registry

BORIS DOI:

10.7892/boris.109206

URI:

https://boris.unibe.ch/id/eprint/109206

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