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Dural lesions in decompression for lumbar spinal stenosis: incidence, risk factors and effect on outcome

  • Eurospine Full Paper Award 2011
  • Published:
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Abstract

Introduction

Decompression for lumbar spinal stenosis is one of the most frequent operations on the spine today. The most common complication seems to be a peroperative dural lesion. There are few prospective studies on this complication regarding incidence and effect on long-term outcome; this is the background for the current study.

Materials and methods

Swespine, the Swedish Spine Register documents the majority (>80%) of lumbar spine operations in Sweden today. Within the framework of this register, totally 3,699 operations for spinal stenosis during a 5-year period were studied regarding complications and 1-year postoperative outcome. Mean patient age was 66 (37–92) years and 44% were males. Fourteen percent were smokers and 19% had undergone previous lumbar spine surgery.

Results

The overall incidence of a peroperative dural lesion was 7.4%, 8.5% of patients undergoing decompressive surgery only and 5.5% of patients undergoing decompressive surgery + fusion (p < 0.001). A logistic regression analysis demonstrated that (high) age (p < 0.0004), previous surgery (p < 0.036) and smoking (p < 0.049) were significantly predictive factors for dural lesions. An odds ratio estimate demonstrated an age-related risk increase with 2.7% per year. The risk for dural lesions also increased with number of levels decompressed. The 1-year outcome was identical in the two groups with and without a dural lesion.

Conclusion

A dural lesion was seen in 7.4% of decompressive operations for spinal stenosis. High age, previous surgery and smoking were risk factors for sustaining a lesion, which, however, did not affect the 1-year outcome negatively.

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Acknowledgments

The authors highly appreciate statistical help and advice given by Caddie Zhou at the National Centre for Quality Registers, Lund Sweden. The economical funding by the Swedish Association of Local Authorities and Regions (SALAR) is also acknowledged.

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Authors and Affiliations

  1. Swedish Society of Spinal Surgeons, Department of Orthopedics, Clinical Sciences Lund, Lund University Hospital, Lund University, SE-221 85, Lund, Sweden

    Fredrik Strömqvist, Bo Jönsson & Björn Strömqvist

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  1. Fredrik Strömqvist
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  2. Bo Jönsson
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  3. Björn Strömqvist
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Swedish Society of Spinal Surgeons

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Correspondence to Björn Strömqvist.

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Strömqvist, F., Jönsson, B., Strömqvist, B. et al. Dural lesions in decompression for lumbar spinal stenosis: incidence, risk factors and effect on outcome. Eur Spine J 21, 825–828 (2012). https://doi.org/10.1007/s00586-011-2101-2

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  • DOI: https://doi.org/10.1007/s00586-011-2101-2

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