Outcomes after incidental durotomy during first-time lumbar discectomy: Clinical article

Atman Desai*, Perry A. Ball, Kimon Bekelis, Jon D. Lurie, Sohail K. Mirza, Tor D. Tosteson, James Neil Weinstein

*Corresponding author for this work

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Object. Incidental durotomy is an infrequent but well-recognized complication during lumbar disc surgery. The effect of a durotomy on long-term outcomes is, however, controversial. The authors sought to examine whether the occurrence of durotomy during surgery impacts long-term clinical outcome. Methods. Spine Patient Outcomes Research Trial (SPORT) participants who had a confirmed diagnosis of intervertebral disc herniation and were undergoing standard first-time open discectomy were followed up at 6 weeks and at 3, 6, and 12 months after surgery and annually thereafter at 13 spine clinics in 11 US states. Patient data from this prospectively gathered database were reviewed. As of May 2009, the mean (± SD) duration of follow-up among all of the intervertebral disc herniation patients whose data were analyzed was 41.5 ± 14.5 months (41.4 months in those with no durotomy vs 40.2 months in those with durotomy, p < 0.68). The median duration of follow-up among all of these patients was 47 months (range 1-95 months). Results. A total of 799 patients underwent first-time lumbar discectomy. There was an incidental durotomy in 25 (3.1%) of these cases. There were no significant differences between the durotomy and no-durotomy groups with respect to age, sex, race, body mass index, herniation level or type, or the prevalence of smoking, diabetes, or hypertension. When outcome differences between the groups were analyzed, the durotomy group was found to have significantly increased operative duration, operative blood loss, and length of inpatient stay. However, there were no significant differences in incidence rates for nerve root injury, postoperative mortality, additional surgeries, or SF-36 scores for Bodily Pain or Physical Function, or Oswestry Disability Index scores at 1, 2, 3, or 4 years. Conclusions. Incidental durotomy during first-time lumbar discectomy does not appear to impact long-term outcome in affected patients.

Original languageEnglish (US)
Pages (from-to)647-653
Number of pages7
JournalJournal of Neurosurgery: Spine
Volume14
Issue number5
DOIs
StatePublished - May 2011

Keywords

  • Clinical outcome
  • Durotomy
  • Lumbar spine
  • Surgical complication

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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    Desai, A., Ball, P. A., Bekelis, K., Lurie, J. D., Mirza, S. K., Tosteson, T. D., & Weinstein, J. N. (2011). Outcomes after incidental durotomy during first-time lumbar discectomy: Clinical article. Journal of Neurosurgery: Spine, 14(5), 647-653. https://doi.org/10.3171/2011.1.SPINE10426