Skip to main content

Advertisement

SpringerLink
Log in

Incidence and risk factors for incidental durotomy in spine surgery for lumbar stenosis and herniated disc

  • Original Article - Spine degenerative
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Purpose

Incidental durotomy (ID) is one of the most common complications in degenerative surgery. Due to the negative consequences of ID, knowledge about incidence and risk factors is warranted.

Methods

A total of 1,139 surgical procedures for lumbar spinal stenosis (LS) and lumbar herniated disc (LDH) were included from the spine surgery database: DaneSpine. Uni- and multivariate analyses were performed for the assessment of possible risk factors.

Results

ID occurred in 10.4% of the surgical procedures. A multivariate regression analysis revealed an increased relative risk of ID by 2% per year of age, 58% by revision surgery, and 55% by decompression on multiple levels.

Conclusion

In our single-centre cohort study, one in ten patients experiences an ID. Increasing age, revision surgery and decompression of multiple levels are risk factors of ID in degenerative surgery of the lumbar spine.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Albayrak S, Ozturk S, Ayden O, Ucler N (2016) Dural tear: a feared complication of lumbar discectomy. Turk Neurosurg 26:918–921

    PubMed  Google Scholar 

  2. Baker GA, Cizik AM, Bransford RJ, Bellabarba C, Konodi MA, Chapman JR, Lee MJ (2012) Risk factors for unintended durotomy during spine surgery: a multivariate analysis. Spine J 12:121–126

    Article  Google Scholar 

  3. Bawany FI, Emaduddin M, Shahid M, Hussain M, Yousuful Islam M, Khan MS (2015) Incidence of pinhole type durotomy and subsequent cerebrospinal fluid leakage following simple laminectomy. Asian Spine J 9:529–534

    Article  Google Scholar 

  4. Chen Z, Shao P, Sun Q, Zhao D (2015) Risk factors for incidental durotomy during lumbar surgery: a retrospective study by multivariate analysis. Clin Neurol Neurosurg 130:101–104

    Article  Google Scholar 

  5. Desai A, Ball PA, Bekelis K, Lurie J, Mirza SK, Tosteson TD, Weinstein JN (2011) SPORT: does incidental durotomy affect long-term outcomes in cases of spinal stenosis? Neurosurgery 69:38–44 (discussion 44)

    Article  Google Scholar 

  6. Enders F, Ackemann A, Müller S, Kiening K, Orakcioglu B (2018) Risk factors and management of incidental durotomy in lumbar interbody fusion surgery. Clin Spine Surg 31:127–131

    Article  Google Scholar 

  7. Herren C, Sobottke R, Mannion AF, Zweig T, Munting E, Otten P, Pigott T, Siewe J, Aghayev E (2017) Incidental durotomy in decompression for lumbar spinal stenosis: incidence, risk factors and effect on outcomes in the Spine Tango registry. Eur Spine J 26:2483–2495

    Article  Google Scholar 

  8. Ishikura H, Ogihara S, Oka H, Maruyama T, Inanami H, Miyoshi K, Matsudaira K, Chikuda H, Azuma S, Kawamura N, Yamakawa K, Hara N, Oshima Y, Morii J, Saita K, Tanaka S, Yamazaki T (2017) Risk factors for incidental durotomy during posterior open spine surgery for degenerative diseases in adults: a multicenter observational study. PLoS ONE 12:e0188038

    Article  Google Scholar 

  9. Papavero L, Engler N, Kothe R (2015) Incidental durotomy in spine surgery: first aid in ten steps. Eur Spine J 24:2077–2084

    Article  Google Scholar 

  10. Pereira BJ, de Holanda CV, Ribeiro CA, Holanda LF, Cabral CD, Caravalho LL, de Oliveira JG (2016) Spinal surgery for degenerative lumbar spine disease: predictors of outcome. Clin Neurol Neurosurg 140:1–5

    Article  Google Scholar 

  11. Simony A, Hansen KH, Ernst C, Andersen M (2014) Implementation of the Danish national database Danespine for spinal surgery. Ugeskr Laeger 176:V01130019

    PubMed  Google Scholar 

  12. Sin AH, Caldito G, Smith D, Rashidi M, Willis B, Nanda A (2006) Predictive factors for dural tear and cerebrospinal fluid leakage in patients undergoing lumbar surgery. J Neurosurg Spine 5:224–227

    Article  Google Scholar 

  13. Smorgick Y, Baker KC, Herkowitz H, Montgomery D, Badve SA, Bachison C, Ericksen S, Fischgrund JS (2015) Predisposing factors for dural tear in patients undergoing lumbar spine surgery. J Neurosurg Spine 22:483–486

    Article  Google Scholar 

  14. Strömqvist B, Fritzell P, Hägg O, Jönsson B (2009) The Swedish Spine Register: development, design and utility. Eur Spine J 18(Suppl 3):294–304

    Article  Google Scholar 

  15. Strömqvist F, Jönsson B, Strömqvist B (2010) Dural lesions in lumbar disc herniation surgery: incidence, risk factors, and outcome. Eur Spine J 19:439–442

    Article  Google Scholar 

  16. Strömqvist F, Jönsson B, Strömqvist B (2012) Dural lesions in decompression for lumbar spinal stenosis: incidence, risk factors and effect on outcome. Eur Spine J 21:825–828

    Article  Google Scholar 

  17. Strömqvist F, Sigmundsson FG, Strömqvist B, Jönsson B, Karlsson MK (2019) Incidental durotomy in degenerative lumbar spine surgery - a register study of 64,431 operations. Spine J 19:624–630

    Article  Google Scholar 

  18. Takahashi Y, Sato T, Hyodo H, Kawamata T, Takahashi E, Miyatake N, Tokunaga M (2013) Incidental durotomy during lumbar spine surgery: risk factors and anatomic locations: clinical article. J Neurosurg Spine 18:165–169

    Article  Google Scholar 

  19. Takenaka S, Makino T, Sakai Y, Kashii M, Iwasaki M, Yoshikawa H, Kaito T (2019) Dural tear is associated with an increased rate of other perioperative complications in primary lumbar spine surgery for degenerative diseases. Medicine (Baltimore) 98:e13970

    Article  Google Scholar 

  20. Tsutsumimoto T, Yui M, Uehara M, Ohta H, Kosaku H, Misawa H (2014) A prospective study of the incidence and outcomes of incidental dural tears in microendoscopic lumbar decompressive surgery. Bone Joint J 96-b:641–645

    Article  CAS  Google Scholar 

  21. Yoshihara H, Yoneoka D (2013) Incidental dural tear in lumbar spinal decompression and discectomy: analysis of a nationwide database. Arch Orthop Trauma Surg 133:1501–1508

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cense Spine, Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark

    Teresa Haugaard Nielsen, Mikkel Mylius Rasmussen & Mathias Møller Thygesen

  2. Comparative Medicine Lab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

    Teresa Haugaard Nielsen & Mathias Møller Thygesen

Authors
  1. Teresa Haugaard Nielsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mikkel Mylius Rasmussen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mathias Møller Thygesen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Teresa Haugaard Nielsen.

Ethics declarations

Ethics approval

The study protocol was approved according to the local legislation.

Informed consent

Patients included in DaneSpine consent individually to data storage and usage.

Conflict of interest

The authors declare no competing interests. The material has not been published or submitted for publication elsewhere.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Spine degenerative

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nielsen, T.H., Rasmussen, M.M. & Thygesen, M.M. Incidence and risk factors for incidental durotomy in spine surgery for lumbar stenosis and herniated disc. Acta Neurochir 164, 1883–1888 (2022). https://doi.org/10.1007/s00701-022-05259-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-022-05259-x

Keywords

Search

Navigation