ORIGINAL ARTICLE   

Journal of Neurosurgical Sciences 2020 December;64(6):499-501

DOI: 10.23736/S0390-5616.18.04381-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

The degree of invasiveness has no influence on the rate of incidental durotomies in surgery for lumbar spinal canal stenosis: data from the German spine registry

Juan M. VINAS-RIOS ¹ ✉, Fatima A. MEDINA-GOVEA ², Viktor VON BEEG-MORENO ³, Frerk MEYER ⁴, DWG Registry-group

¹ Department of Spine Surgery, Sana Klinikum Offenbach, Offenbach, Germany; ² Unit of Clinical Epidemiology, University of San Luis Potosí, San Luis Potosí, Mexico; ³ Faculty of Medicine, Johann W. Goethe University, Frankfurt am Main, Germany; ⁴ Evangelic University Hospital of Oldenburg, Oldenburg, Germany

BACKGROUND: Risk factors for incidental durotomies are good documented by some authors who consider the degree of invasiveness as a direct risk factor on this serious complication. We compared the rate of incidental durotomies and its dependence from the degree of invasiveness.
METHODS: The German Spine Registry could document 6016 surgeries for lumbar spinal canal stenosis, N.=2539 microsurgical decompression, and N.=2371 open decompression with stabilization.
RESULTS: Both groups were identical concerning age and sex of patients, mean age: 77.1±1.60; females: 58%; males: 32%. There were 410 incidental durotomies, group 1: 209 (8.23%); group 2: 201 (8.47%). This difference is statistically not relevant (P=0,75). A surgical therapy is documented in 345 (84%) cases, suture with/without fibrin glue: group 1=162 and group 2=183. Fifty-nine patients had a persistent fistula that needed treatment with a lumbar drain, group 1: N.=30; and group 2: N.=29.
CONCLUSIONS: The groups decompression vs. decompression plus fusion are statistically comparable. Although the stabilization with instrumentation is a more invasive procedure with longer operation times, trauma tissue and blood loss - in comparison with microsurgical decompression - showed no difference in the rate of incidental durotomies.

KEY WORDS: Spinal canal; Tears; Blood loss, surgical