Incidental dural tears during pediatric posterior spinal fusions

Area of Science:

• Neurosurgery
• Pediatric Orthopedics
• Spinal Surgery

Background:

• Incidental dural tears can occur during pediatric spine surgery.
• Understanding their frequency and outcomes is crucial for patient care.

Purpose of the Study:

• To determine the incidence of incidental dural tears in pediatric posterior spinal fusion (PSF).
• To analyze the treatment, complications, and long-term outcomes of these tears.

Main Methods:

• Retrospective review of 3043 pediatric PSF procedures (2004-2019).
• Analysis of electronic medical records for dural tear occurrence, repair, and patient outcomes.
• Level IV evidence.

Main Results:

• An overall incidence of 3.3% for incidental dural tears was observed (99 tears in 94 patients).
• Tears were more frequent in revision PSF (6.2%) versus primary PSF (2.6%).
• 86.9% of tears were repaired intraoperatively; 13.1% resolved spontaneously. Postoperative headaches occurred in 13.1% and resolved within 7.6 days. Infections occurred in 9.5%.

Conclusions:

• The incidence of intraoperative dural tears in pediatric spine surgery is 3.3%.
• While complications like headaches can occur, they generally resolve without long-term sequelae.
• Most dural tears are managed effectively with intraoperative repair or spontaneous resolution.