Frequency of Incidental Durotomy during Surgery for Degenerative Lumbar Spine Disease

Authors

  • Abdul Aziz Khan Department of Neurosurgery, Ayub Medical College and Hospital, Abbottabad, Pakistan
  • Amer Zaman
  • Baynzair Khan
  • Attiya Nasir Siddique
  • Idrees Ahmed
  • Mohammad Waseem

DOI:

https://doi.org/10.36552/pjns.v26i1.660

Abstract

Objective:  One of the most common treatments performed in a neurosurgical facility for lower back pain and claudication is degenerative lumbar spine surgery. The study aimed to determine the frequency of incidental durotomy during surgery for degenerative lumbar spine diseases. Materials and Methods:  In this study, a total of 95 patients were included from the Department of Neurosurgery, Ayub Teaching Hospital, Abbottabad. After the patient’s selection, their history, examination, and investigations, surgery was carried out by consultant neurosurgeons. Per-operatively unintentional dural tears were identified as rent in dura with or without CSF leak and were either repaired primarily or by applying fibrin glue if the repair was not possible. Results:  The mean age was 38 ± 12.62 years. Fifty-eight percent of patients were male and 42% of patients were females. More than 6% of patients had incidental durotomy while 94% of patients didn’t have incidental durotomy. Recurrent disc prolapse was found in 5% of the cases. One percent of incidental durotomy patients were also recurrent instances, accounting for 6% of the total. Whereas 95% of patients did not require a durotomy, the surgery went smoothly. Conclusion:  The frequency of incidental durotomy was 6% during surgery for degenerative lumbar spine diseases.

Keywords:  Incidental durotomy, Degenerative Lumbar Spine, Spinal Stenosis, Spinal Surgery

References

Ullah W, Ali M, Khan Z. Frequency of incidental durotomy during surgery for degenerative lumbar spine disease: An experience in neurosurgery department of a tertiary care hospital. J Postgrad Med Inst. 2018; 32 (1): 99–102.

Blecher R, Anekstein Y, Mirovsky Y. Incidental Dural Tears during Lumbar Spine Surgery: A Retrospective Case Study of 84 Degenerative Lumbar Spine Patients. Asian Spine J. 2014; 8 (5): 639–45.

Bydon M, Macki M, Abt NB, Sciubba DM, Wolinsky JP, Witham TF, et al. Clinical and surgical outcomes after lumbar laminectomy: An analysis of 500 patients. Surg Neurol Int. 2015; 6 (Suppl. 4): 190–3.

Adam D, Papacocea T, Iliescu R, Hornea I,Moisescu C. Incidental durotomy in lumbar spine surgery – incidence, risk factors and management. Romanian Neurosurg. 2015; 22 (1): 20–6.

Abdul Wahid T, Abdul Wahid AT, Salah A. Unintended durotomy during degenerative lumbar spine surgery (Incidence and management). J Fac Med Baghdad, 2014; 56 (4): 347–51.

Ayub S, urRehman R, Khattak RU. Incidence and Management Outcome of Incidental Durotomy in Spinal Procedures in Tertiary Care Hospital. Pak J Neurol Surg. 2017; 21 (3): 155–8.

Meng YB, He X, Huang YF, Wu QN, Zhou YC, Hao DJ. Multivariate analysis of risk factors for predicting incidental durotomy in lumbar surgery. Int J Clin Exp Med. 2016; 9 (10): 20014–9.

Ulrich NH, Burgstaller JM, Brunner F, Porchet F, Farshad M, Pichierri G, et al. The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: analysis of the Lumbar Spinal Outcome Study (LSOS) data – a Swiss prospective multi-center cohort study. BMC Musculoskelet Disord. 2016; 17 (1): 170.

Ali M, Khan HM, Khanzada K, Usman M, Hussain R, Rehman Z. Level of spinal involvement in patients operated for spinal tuberculosis. J Postgrad Med Inst. 2012; 26 (4): 439-43.

The Express Tribune. Tuberculosis attacks the spine in 6 out of every 10 cases [Online]. 2010 [cited on 2012 Sep 15]. Available from URL:

http://tribune.com.pk/story/12213/tuberculosis-attacks-the-spine-in-6-out-of-every-10-cases/

Aryan HE, Lu DC, Acosta FL, Ames CP. Corpectomy followed by the placement of instrumentation with titanium cages and recombinant human bone morphogenetic protein-2 for vertebral osteomyelitis. J Neurosurg. 2007; 6 (1): 23-30.

Ullah W, Ali M, Khan Z. Frequency of incidental durotomy during surgery for degenerative lumbar spine disease: an experience in neurosurgery department lady reading hospital Peshawar. J Postgrad Med Inst. 2018; 32 (1): 99-102.

Abdul Wahid T, Abdul Wahid AT, Salah A. Unintended durotomy during degenerative lumbar spine surgery (Incidence and management). J Fac Med Baghdad, 2014; 56: 347-51.

Khan JA, Yadav SK, Tian R, Xia G, Xu T, Jia Y. Outcome of Incidental Unrepaired Dural Tear during Lumbar Spine Surgery: Comparisons of Subfacial Drain with or without Subarachnoid Drain. J Spine Neurosurg. 2015; 4: 1.

Takahashi Y, Sato T, Hyodo H, Kawamata T, Takahashi E, Miyatake N, Tokunaga M. Incidental durotomy during lumbar spine surgery: risk factors and anatomic locations: clinical article. J Neurosurg Spine, 2013; 18 (2): 165-9.

Khan Z, Sharafat S, Siddique M, Ali M, Alam I. Incidental durotomy during degenerative lumbar spine surgery: incidence and risk factors. KUST J Med Sci. 2013; 6 (2): 293-95.

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Published

2022-03-31