The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: analysis of the Lumbar Spinal Outcome Study LSOS data—a Swiss prospective multi-center cohort studyReport as inadecuate




The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: analysis of the Lumbar Spinal Outcome Study LSOS data—a Swiss prospective multi-center cohort study - Download this document for free, or read online. Document in PDF available to download.

BMC Musculoskeletal Disorders

, 17:170

Orthopedics and biomechanics

Abstract

BackgroundIncidental durotomy is a well-known complication during surgery for degenerative lumbar spinal stenosis DLSS. In this prospective multicenter cohort study including eight medical centers our aim was to assess whether incidental durotomy during first-time lumbar spinal stenosis decompression surgery without fusion has an impact on long-term outcome.

MethodsPatients of the multi-center Lumbar Stenosis Outcome Study LSOS with confirmed DLSS undergoing first-time decompression without fusion were enrolled in this study. Baseline patient characteristics and outcomes were analyzed at 6, 12, and 24 months follow-up respectively with the Spinal Stenosis Measure SSM, the Numeric Rating Scale NRS, Feeling Thermometer FT, the EQ-5D-EL, and the Roland and Morris Disability Questionnaire RMDQ.

ResultsA total of 167 patients met the inclusion criteria. Fifteen 9 % of those patients had an incidental durotomy. Baseline characteristics were similar between the durotomy and no-durotomy group. All patients improved over time. In the group of durotomy patients, the median improvement in SSM symptoms scale was 1.1 points at 6 months, 1.1 points at 12 months, and 1.6 points at 24 months after baseline. For the no-durotomy group, these improvements were 0.8, 0.9, and 0.9. For SSM function the improvements were 1.0, 0.8, and 0.9 in the durotomy group, and 0.6, 0.8, and 0.8 in the no-durotomy group. None of the between-group differences were statistically significant.

ConclusionsIncidental durotomy in patients with DLSS undergoing first-time decompression surgery without fusion did not have negative effect on long-term outcome and quality of life. However, only 15 patients were included in the durotomy group but these findings remained even after adjusting for observed differences in baseline characteristics.

KeywordsDurotomy Dural tear Decompression Degenerative lumbar spinal stenosis Multi-center Surgery AbbreviationsCIRScumulative illness rating scale

DLSSdegenerative lumbar spinal stenosis

FTfeeling thermometer

HADShospital anxiety and depression scale

IQRinterquartile range

LSOSlumbar stenosis outcome study

LSSlumbar spinal stenosis

MRImagnetic resonance imaging

NASSnorth american spine society

nrsthe numeric rating scale

RMDQroland and morris disability questionnaire

SSMspinal stenosis measure

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