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preLekára.sk / Journals / Perspectives in Surgery / 2020 - 2

Unintended durotomy during degenerative lumbar spine surgery in patients aged 60 years and older – incidence and risk factors

Česká verzia

Authors: P. Snopko;  B. Kolarovszki;  R. Opšenák;  M. Hanko;  M. Masaryková;  M. Benčo
Authors place of work: Neurochirurgická klinika, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin
Published in the journal: Rozhl. Chir., 2020, roč. 99, č. 2, s. 67-71.
Category: Original articles

Summary

ntroduction: Unintended perioperative dural tear is a common complication in spine surgery.

Methods: Retrospective analysis of patients over 60 years of age who underwent surgery for degenerative disease of the lumbar spine at the Department of Neurosurgery (University Hospital in Martin) from January 2016 to December 2017. Incidence of incidental perioperative durotomy was analyzed. We analyzed selected risk factors − gender, ASA (American Society of Anesthesiologists), surgical diagnosis, type of surgical performance, range of surgical procedure, revision surgery and comorbidities. The results were statistically evaluated using descriptive statistics and Fisher›s test. Results with p<0.05 were considered statistically significant.

Results: Our group consisted of 166 patients, 70 men and 96 women (42.2%/57.8%). Perioperative dural tear occurred in 23 patients (13.8%). Increased incidence of dural tear was at level L4/L5 (56.5%). Results showed a statistically significant increased incidence of iatrogenic durotomy in women compared to men (7.1%/18.7%; p=0.0404). Spondylolisthesis was considered as a statistically significant risk factor of an incidental dural tear (p=0.0125). We found a statistically significant relationship between the presence of type II diabetes mellitus (p=0.0397), osteoporosis (p=0.0166) and the presence of peroperative incidental durotomy.

Conclusion: Our retrospective study showed a statistically significant increased incidence of incidental peroperative durotomy in females compared to males, in patients with spondylolisthesis, in patients with type II. diabetes mellitus and osteoporosis. Dural tear occurred most commonly at the level of L4 / L5.

Keywords:

incidental durotomy – spine surgery – risk factors

Zdroje
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Perspectives in Surgery

Číslo 2
2020 Číslo 2
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