title: Risk factors for dural tears: a study of elective spine surgery.
abstract: OBJECTIVE
  This study moves beyond previous cohort studies and benchmark data by studying a population of elective spine surgery from a multicenter registry in an effort to validate, disprove, and/or identify novel risk factors for dural tears.
  
  
  METHODS
  A retrospective cohort analysis queried a multicenter registry for patients with degenerative spinal diagnoses undergoing elective spinal surgery from 2010-2014. Multivariable logistic regression analysis interrogated for independent risk factors of dural tears.
  
  
  RESULTS
  Of 104,930 patients, a dural tear requiring repair occurred in 0.6% of cases. On adjusted analysis, the following factors were independently associated with increased likelihood of a dural tear: ankylosing spondylitis vs. intervertebral disc disorders, greater than two levels, combined surgical approach and posterior approach vs. anterior approach, decompression only vs. fusion and decompression, age groups 85+, 75-84 and 65-74 vs. <65, obesity (BMI ≥30), corticosteroid use and preoperative platelet count <150,000.
  
  
  CONCLUSIONS
  This multicenter study identifies novel risk factors for dural tears in the elective spine surgery population, including corticosteroids, thrombocytopenia, and ankylosing spondylitis. The results of this analysis provide further information for surgeons to use both in operative planning and in preoperative counseling when discussing the risk of dural tears.
authors.affiliation: a Department of Neurologic Surgery , Mayo Clinic , Rochester , MA , USA.|b Mayo Clinic Neuro-Informatics Laboratory , Mayo Clinic , Rochester , MA , USA.
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Murphy
authors.affiliation: a Department of Neurologic Surgery , Mayo Clinic , Rochester , MA , USA.|b Mayo Clinic Neuro-Informatics Laboratory , Mayo Clinic , Rochester , MA , USA.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kerezoudis
authors.affiliation: a Department of Neurologic Surgery , Mayo Clinic , Rochester , MA , USA.|b Mayo Clinic Neuro-Informatics Laboratory , Mayo Clinic , Rochester , MA , USA.
authors.forename: Mohammed Ali
authors.initials: MA
authors.lastname: Alvi
authors.affiliation: a Department of Neurologic Surgery , Mayo Clinic , Rochester , MA , USA.|b Mayo Clinic Neuro-Informatics Laboratory , Mayo Clinic , Rochester , MA , USA.
authors.forename: Brandon A
authors.initials: BA
authors.lastname: McCutcheon
authors.affiliation: a Department of Neurologic Surgery , Mayo Clinic , Rochester , MA , USA.|b Mayo Clinic Neuro-Informatics Laboratory , Mayo Clinic , Rochester , MA , USA.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Maloney
authors.affiliation: a Department of Neurologic Surgery , Mayo Clinic , Rochester , MA , USA.|b Mayo Clinic Neuro-Informatics Laboratory , Mayo Clinic , Rochester , MA , USA.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rinaldo
authors.affiliation: a Department of Neurologic Surgery , Mayo Clinic , Rochester , MA , USA.|b Mayo Clinic Neuro-Informatics Laboratory , Mayo Clinic , Rochester , MA , USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Shepherd
authors.affiliation: c Department of Health Sciences Research , Mayo Clinic , Rochester , MA , USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Ubl
authors.affiliation: a Department of Neurologic Surgery , Mayo Clinic , Rochester , MA , USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Krauss
authors.affiliation: c Department of Health Sciences Research , Mayo Clinic , Rochester , MA , USA.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Habermann
authors.affiliation: a Department of Neurologic Surgery , Mayo Clinic , Rochester , MA , USA.|b Mayo Clinic Neuro-Informatics Laboratory , Mayo Clinic , Rochester , MA , USA.|d Health Services Research and Neurosurgery and Orthopedics , College of Medicine, Mayo Clinic , Rochester , MA , USA.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Bydon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000009:adverse effects*; D004388:Dura Mater / Q000293:injuries* / Q000473:pathology; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D008297:Male; D012042:Registries; D013167:Spondylitis, Ankylosing / Q000601:surgery*; D016896:Treatment Outcome
keywords: Dural tear; NSQIP; degenerative spine disease; elective spine surgery; incidental durotomy; risk factors