Universität zu Köln

Herren, Christian, Sobottke, Rolf, Mannion, Anne F., Zweig, Thomas, Munting, Everard, Otten, Philippe ORCID: 0000-0002-9799-232X, Pigott, Tim, Siewe, Jan and Aghayev, Emin (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 (10). S. 2483 - 2496. NEW YORK: SPRINGER. ISSN 1432-0932

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Abstract

Purpose The three aims of this Spine Tango registry study of patients undergoing decompression for spinal stenosis were to: report the rate of dural tear (DT) stratified by treatment centre; find factors associated with an increased likelihood of incurring a DT; and compare treatment outcomes in relation to DT (none vs. repaired vs. unrepaired DT). Methods Multivariate logistic regression was used to assess the association between DT and patient and treatment characteristics. Patient-rated and surgical outcomes were compared in patients with no DT, repaired DT, and unrepaired DT, while adjusting for case-mix. Results DT occurred in 328/3254 (10.1%) of included patients. The rate for all 29 contributing hospitals was within 95% confidence intervals of the average. The likelihood of DT increased by 2% per year of age, 1.78 times with previous spine surgery, 1.67 for a minimally/less invasive surgery, 1.58 times with laminectomy, and 1.40, and 2.12 times for BMI 31-35, and > 35 in comparison with BMI 26-30, respectively. The majority of DTs (272/328; 82.9%) were repaired. Repairing the DT was associated with a longer duration of surgery (p < 0.001). More patients with repaired than with unrepaired DTs were satisfied with treatment, but the difference was not statistically significant. There was no association between DT and patient-reported outcomes. Conclusion The unadjusted rate of incidental DT during decompression for LSS was homogeneous across the participating centres and was associated with age, BMI, previous surgery at the same spinal level, minimally/less invasive surgery, and laminectomy. Non-repair of DTs had no negative association with treatment outcome; however, the unrepaired DTs may have been those that were smaller in size.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Herren, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Sobottke, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Mannion, Anne F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zweig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Munting, Everard UNSPECIFIED UNSPECIFIED UNSPECIFIED Otten, Philippe UNSPECIFIED orcid.org/0000-0002-9799-232X UNSPECIFIED Pigott, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Siewe, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Aghayev, Emin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-215418
DOI:	10.1007/s00586-017-5197-1
Journal or Publication Title:	Eur. Spine J.
Volume:	26
Number:	10
Page Range:	S. 2483 - 2496
Date:	2017
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-0932
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DURAL TEARS; MULTIVARIATE-ANALYSIS; UNINTENDED DUROTOMY; CANAL STENOSIS; FLUID LEAKAGE; FIBRIN GLUE; SURGERY; LAMINECTOMY; MANAGEMENT; PATIENT Multiple languages Clinical Neurology; Orthopedics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21541