Incidental Dural Tear in Lumbar Spine Surgery: A Prospective Study

Abstract

Pravin P Bande, Sourav Garnaik, Rajiv V Kulkarni, Sagar Wajekar and Tejal Kothmire

Introduction: Incidental dual tear is a complication of spinal surgery characterized by an accidental nick of the spinal dural sheath during operative procedures. The worldwide incidence of dural tear according to previous literature varies widely (1- 17%) and in general depends on the type and complexity of the procedure. The present was carried to evaluate the incidence of dural tear in lumbar spine surgery, and to study clinical outcomes in terms of VAS score ODI score and length of hospital stay.

Methods: This was a prospective, observational and case control study conducted on 40 patients who underwent elective Lumbosacral spine surgery. The incidence of dural tear was evaluated and the patients were divided into with dural tear and without dural tear. The clinical outcome such as visual analogue scale (VAS) score, Oswestry Disability Index (ODI) score and length of hospital stay were evaluated.

Results: The incidence of Dural tear in our study population was found to be 7.5%. The ODI score was significantly higher in dural tear as compared to without dual tear at various postoperative periods. Further, there was no significant difference in the VAS scores with and without dural tear patients. The length of hospital stay was significantly higher in patients with dural tear as compared to without dural tear (11.63±6.19 vs 3.06±1.02 days; p=0.004).

Conclusion: Incidental Dural tears if detected and managed accordingly, adverse clinical and postoperative outcomes can be reduced effectively and also increases the quality of life in patients.

PDF