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Journal of Neurosurgical Sciences 2018 Oct 10

DOI: 10.23736/S0390-5616.18.04381-3


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 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 Clinic Epidemiology, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico; 3 University Johann W. GoetheFaculty of Medicine, Frankfurt am Main, Germany; 4 University Clinic Evagelical Hospital, Oldenburg, Germany


BACKGROUND: Risk factors for incidental durotomies are good documented claimed from some authors 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, female 58%, male 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. 59 patients had a persistent fistula that needed treatment with a lumbar drain: group 1 n=30 and group 2 =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, more trauma tissue and blood loss in comparison with microsurgical decompression no difference in the rate of incidental durotomies was found.

KEY WORDS: Spinal canal stenosis - Dural tear - German Spine Registry

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