No difference in postoperative complications, pain, and functional outcomes up to 2 years after incidental durotomy in lumbar spinal fusion: a prospective, multi-institutional, propensity-matched analysis of 1,741 patients

被引：36

作者：

Adogwa, Owoicho ^{[1
]}

Huang, Mary I. ^{[1
]}

Thompson, Paul M. ^{[1
]}

Darlington, Timothy ^{[1
]}

Cheng, Joseph S. ^{[2
]}

Gokaslan, Ziya L. ^{[3
]}

Gottfried, Oren N. ^{[1
]}

Bagley, Carlos A. ^{[1
]}

Anderson, Greg D. ^{[4
]}

Isaacs, Robert E. ^{[1
]}

机构：

[1] Duke Univ, Med Ctr, Div Neurosurg, Durham, NC 27710 USA

[2] Vanderbilt Univ, Med Ctr, Dept Neurosurg, Nashville, TN 37204 USA

[3] Johns Hopkins Univ, Sch Med, Dept Neurosurg, Baltimore, MD 21287 USA

[4] Thomas Jefferson Univ Hosp, Rothman Inst, Dept Orthopaed & Neurol Surg, King Of Prussia, PA 19406 USA

来源：

SPINE JOURNAL | 2014年 / 14卷 / 09期

关键词：

CSF leak; Incidental durotomy; Functional outcomes; Long-term outcomes; Complications; Patient reported outcomes; CEREBROSPINAL-FLUID LEAKAGE; DEGENERATIVE DISEASE; DURAL TEARS; SURGERY; PERFORMANCE; GUIDELINES; MANAGEMENT; OPERATIONS; REPAIR;

D O I：

10.1016/j.spinee.2013.10.023

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

BACKGROUND: Incidental durotomies occur in up to 17% of spinal operations. Controversy exists regarding the short- and long-term consequences of durotomies. PURPOSE: The primary aim of this study was to assess the effect of incidental durotomies on the immediate postoperative complications and patient-reported outcome measures. STUDY DESIGN: Prospective study. PATIENT SAMPLE: A total of 1,741 patients undergoing index lumbar spine fusion were selected from a multi-institutional prospective data registry. OUTCOME MEASURES: Patient-reported outcome measures used in this study included back pain (BP-Visual Analog Scale), leg pain (LP-Visual Analog Scale), and Oswestry Disability Index. METHODS: A total of 1,741 patients were selected from a multi-institutional prospective data registry, who underwent primary lumbar fusion for low back pain and/or radiculopathy between January 2003 and December 2010. We collected and analyzed data on patient demographics, postoperative complications, back pain, leg pain, and functional disability over 2 years, with risk-adjusted propensity score modeling. RESULTS: Incidental durotomies occurred in 70 patients (4%). Compared with the control group (n = 1,671), there was no significant difference in postoperative infection (p = .32), need for reoperation (p = .85), or symptomatic neurologic damage (p = .66). At 1- and 2-year follow-up, there was no difference in patient-reported outcomes of back pain (BP-Visual Analog Scale), leg pain (LP-Visual Analog Scale), or functional disability (Oswestry Disability Index) (p > .3), with results remaining consistent in the propensity-matched cohort analysis (p > .4). CONCLUSION: Within the context of an on-going debate on the consequences of incidental durotomy, we found no difference in neurologic symptoms, infection, reoperation, back pain, leg pain, or functional disability over a 2-year follow-up period. Published by Elsevier Inc.

引用

页码：1828 / 1834

页数：7