Incidence and Management Outcome of Incidental Durotomy in Lumber Spinal Procedures

Nadia Iqbal, Zain ul Abedeen, Riaz ur Rehman

Abstract


Background: Incidental durotomy is a common complication of lumbar spine surgeries. Its incidence depends on several factors
and the incidence varies from center to center.
Objectives: To know the incidence and management outcome of incidental durotomy in neurospinal procedures in a tertiary care
hospital.
Material & Methods: This descriptive study was conducted in neurosurgical unit of Hayatabad Medical Complex, Peshawar from 15 July 2015 to 14 July 2017. Patients in whom incidental durotomy occurred were included in study without age or gender
discrimination. Patients in whom dura was intentionally opened were excluded from the study. Primary repair was attempted in all patients Their ages, gender, indications of surgery were reviewed and subsequent management of durotomy was documented. Patients' data analyzed in SPSS 18.

Results: Amongst 563 patients there were 344(61.10%) male and 319(38.90%) female patients Amongst those operated,
295(52.30%) patients had lumbar disc herniation, 144(25.53%) patients had spinal stenosis, 76(13.47%) patients had traumatic
lumbar vertebral fractures. Incidental dural tear was noticed in 51 (9.04%) patients. Incidence of durotomy was 21(3.36%) in male and 31(5.50%) female patients. We identified dural tears site in all patients during the surgery. Forty six (46=90.20%) dural tears were repaired primarily. Five (3=6%) patients had dural tears in unstichable area .Reexploration was done in 2(3.92%) patient. Kerrison rongeur was responsible for dural tears in 25 patients. In 15 cases dissector tore the dura .
Conclusion: Unintentional duratomy is relatively common complication especially in female and elderly patients.


Keywords


Incidental durotomy, Incidence, Management

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