Dural Tears in Adult Deformity Surgery

Incidence, Risk Factors, and Outcomes

for the International Spine Study Group (ISSG)

Research output: Contribution to journalArticle

Abstract

Study Design: Retrospective cohort study. Objectives: Describe the rate of dural tears (DTs) in adult spinal deformity (ASD) surgery. Describe the risk factors for DT and the impact of this complication on clinical outcomes. Methods: Patients with ASD undergoing surgery between 2008 and 2014 were separated into DT and non-DT cohorts; demographics, operative details, radiographic, and clinical outcomes were compared. Statistical analysis included t tests or χ2 tests as appropriate and a multivariate analysis. Results: A total of 564 patients were identified. The rate of DT was 10.8% (n = 61). Patients with DT were older (61.1 vs 56.5 years, P =.005) and were more likely to have had prior spine surgery (odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.2-3.3, P =.007). DT patients had higher pelvic tilt, lower lumbar lordosis, and greater pelvic-incidence lumbar lordosis mismatch than non-DT patients (P <.05). DT patients had longer operative times (424 vs 375 minutes, P =.008), were more likely to undergo interbody fusions (OR = 2.0, 95% CI = 1.1-3.6, P =.021), osteotomies (OR = 2.2, 95% CI = 1.1-4.0, P =.012), and decompressions (OR = 2.3, 95% CI = 1.3-4.3, P =.003). In our multivariate analysis, only decompressions were associated with an increased risk of DT (OR = 3.2, 95% CI = 1.4-7.6, P =.006). There were no significant differences in patient outcomes at 2 years. Conclusions: The rate of DT was 10.8% in an ASD cohort. This is similar to rates of DT reported following surgery for degenerative pathology. A history of prior spine surgery, decompression, interbody fusion, and osteotomies are all associated with an increased risk of DT, but decompression is the only independent risk factor for DT.

Original languageEnglish (US)
Pages (from-to)25-31
Number of pages7
JournalGlobal Spine Journal
Volume8
Issue number1
DOIs
StatePublished - Feb 1 2018

Fingerprint

Tears
Incidence
Decompression
Odds Ratio
Confidence Intervals
Lordosis
Osteotomy
Spine
Multivariate Analysis
Operative Time
Cohort Studies
Retrospective Studies
Demography

Keywords

  • adult spinal deformity
  • complications
  • dural tears
  • durotomy
  • incidental durotomy
  • osteotomy

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Dural Tears in Adult Deformity Surgery : Incidence, Risk Factors, and Outcomes. / for the International Spine Study Group (ISSG).

In: Global Spine Journal, Vol. 8, No. 1, 01.02.2018, p. 25-31.

Research output: Contribution to journalArticle

for the International Spine Study Group (ISSG). / Dural Tears in Adult Deformity Surgery : Incidence, Risk Factors, and Outcomes. In: Global Spine Journal. 2018 ; Vol. 8, No. 1. pp. 25-31.
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