Risk Factors for Accidental Dural Tears in Spinal Surgery
Zeiad A F Alshameeri1, Vinay Jasani1
1University Hospital of North Midlands, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom.
International Journal of Spine Surgery
|May 14, 2021
Summary
Accidental dural tears (DTs) during spinal surgery are a known complication. Advanced age, revision surgery, and lumbar stenosis significantly increase the risk of DTs, necessitating careful consideration during patient consent.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Surgical Complications
Background:
- Accidental dural tears (DTs) are common complications in spinal surgery.
- The incidence and risk factors for DTs require further investigation.
Purpose of the Study:
- To systematically review and meta-analyze the incidence rate of DTs.
- To identify and assess risk factors associated with DTs in spinal surgery.
Main Methods:
- Systematic literature search using MeSH and Text terms.
- Inclusion of prospective studies reporting DT incidence and risk factors.
- Meta-analysis to pool incidence rates and assess risk factor associations.
Main Results:
- Pooled incidence rate of DTs was 5.8% (95% CI 4.4-7.3).
- Significant risk factors for DTs included advanced age (MD 3.04), revision surgery (OR 2.28), and lumbar stenosis (OR 2.03).
- Diabetes showed a weak association (OR 1.40); sex and obesity were not significant.
Conclusions:
- Advancing age, revision surgery, and lumbar stenosis are significant risk factors for DTs.
- These identified risk factors should be integrated into the informed consent process for spinal surgery.
- Understanding these factors can help mitigate DT risks.
