[Iatrogenic dural lesions in lumbar neural decompressive surgery].
BACKGROUND
Iatrogenic dural tear with cerebrospinal fluid leakage is a known complication of lumbar surgery of the columna. In the literature, the incidence is 3-16%.


METHODS
The study was a retrospective, consecutive review of electronic patient records after spinal surgery at the Private Hospital Hamlet. The study covers cases from the 10-month period from September 1, 2007 to June 30, 2008. Data was collected after this period and consists of surgeon-documented dural tears. At the time of surgery, the surgeon was unaware that there would be a subsequent registration. A total of 634 patients had lumbar neural decompressive surgery - 479 patients were treated for spinal stenosis and 155 for prolapsed disc.


RESULTS
The incidence of dural tear was 3.9% (25 dural tears in 634 operations). The risk of a dural tear after secondary surgery was 7.9% versus 3.3% for primary (p = 0.02) and the mean age was 65.9 years for patients with dural tear compared with 58.1 years for patients without (p = 0.00). The difference in the mean duration of surgery was significant being 72 minutes in the group suffering a dural tear compared with 56 minutes (p = 0.03) among the remaining patients, and in the former group length of stay was increased by 1.1 day (p = 0.00).


CONCLUSIONS
The incidence of iatrogenic dural tear was 3.9%. The incidence of dural tear was doubled in secondary surgery. The duration of surgery increased by 16 minutes and the patients with dural tear were also hospitalized one day longer.
Thomsen
Frederik
F
Privathospitalet, Hamlet A/S, Denmark. thomsen.frederik@gmail.com
Amtoft
Ole
O
Andersen
Mikkel
M
Bøge-Rasmussen
Torben
T
Jensen
Tim Toftgaard
TT
Jensen
Lars Emil
LE
Jespersen
Stig
S
Kruse
Anders
A
Thomsen
Karsten
K
D019299:Decompression, Surgical / Q000009:adverse effects*; D004388:Dura Mater / Q000293:injuries*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D007431:Intraoperative Complications / Q000209:etiology; D008159:Lumbar Vertebrae / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013130:Spinal Stenosis / Q000601:surgery