title: [Iatrogenic dural lesions in lumbar neural decompressive surgery].
abstract: 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.
authors.affiliation: Privathospitalet, Hamlet A/S, Denmark. thomsen.frederik@gmail.com
authors.forename: Frederik
authors.initials: F
authors.lastname: Thomsen
authors.forename: Ole
authors.initials: O
authors.lastname: Amtoft
authors.forename: Mikkel
authors.initials: M
authors.lastname: Andersen
authors.forename: Torben
authors.initials: T
authors.lastname: Bøge-Rasmussen
authors.forename: Tim Toftgaard
authors.initials: TT
authors.lastname: Jensen
authors.forename: Lars Emil
authors.initials: LE
authors.lastname: Jensen
authors.forename: Stig
authors.initials: S
authors.lastname: Jespersen
authors.forename: Anders
authors.initials: A
authors.lastname: Kruse
authors.forename: Karsten
authors.initials: K
authors.lastname: Thomsen
mesh_terms: 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