The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: analysis of the Lumbar Spinal Outcome Study (LSOS) data—a Swiss prospective multi-center cohort study

BMC Musculoskeletal Disorders

Research Article

François Porchet¹  Jakob M. Burgstaller²  Johann Steurer²  Giuseppe Pichierri²  Ulrike Held²  Nils H. Ulrich³  Florian Brunner⁴  Mazda Farshad⁴ 

[1] Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, Zurich, Switzerland;Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistr. 24, 8091, Zürich, Switzerland;Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Pestalozzistr. 24, 8091, Zürich, Switzerland;Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, Zurich, Switzerland;Spine Division, Balgrist University Hospital, University of Zurich, Zürich, Switzerland;

关键词: Durotomy;    Dural tear;    Decompression;    Degenerative lumbar spinal stenosis;    Multi-center;    Surgery;   

DOI  :  10.1186/s12891-016-1022-y

 received in 2015-08-28, accepted in 2016-04-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundIncidental durotomy is a well-known complication during surgery for degenerative lumbar spinal stenosis (DLSS). In this prospective multicenter cohort study including eight medical centers our aim was to assess whether incidental durotomy during first-time lumbar spinal stenosis decompression surgery without fusion has an impact on long-term outcome.MethodsPatients of the multi-center Lumbar Stenosis Outcome Study (LSOS) with confirmed DLSS undergoing first-time decompression without fusion were enrolled in this study. Baseline patient characteristics and outcomes were analyzed at 6, 12, and 24 months follow-up respectively with the Spinal Stenosis Measure (SSM), the Numeric Rating Scale (NRS), Feeling Thermometer (FT), the EQ-5D-EL, and the Roland and Morris Disability Questionnaire (RMDQ).ResultsA total of 167 patients met the inclusion criteria. Fifteen (9 %) of those patients had an incidental durotomy. Baseline characteristics were similar between the durotomy and no-durotomy group. All patients improved over time. In the group of durotomy patients, the median improvement in SSM symptoms scale was 1.1 points at 6 months, 1.1 points at 12 months, and 1.6 points at 24 months after baseline. For the no-durotomy group, these improvements were 0.8, 0.9, and 0.9. For SSM function the improvements were 1.0, 0.8, and 0.9 in the durotomy group, and 0.6, 0.8, and 0.8 in the no-durotomy group. None of the between-group differences were statistically significant.ConclusionsIncidental durotomy in patients with DLSS undergoing first-time decompression surgery without fusion did not have negative effect on long-term outcome and quality of life. However, only 15 patients were included in the durotomy group but these findings remained even after adjusting for observed differences in baseline characteristics.

【 授权许可】

CC BY   
© Ulrich et al. 2016