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. 2022 Aug;16(4):463-470.
doi: 10.31616/asj.2021.0140. Epub 2021 Nov 18.

Incidence of Dural Tears in Open versus Minimally Invasive Spine Surgery: A Single-Center Prospective Study

Ayush Sharma  1 , Akash Shakya  1 , Vijay Singh  1 , Priyank Deepak  1 , Nilesh Mangale  1 , Ajay Jaiswal  1 , Nandan Marathe  1
Affiliations

Incidence of Dural Tears in Open versus Minimally Invasive Spine Surgery: A Single-Center Prospective Study

Ayush Sharma et al. Asian Spine J. 2022 Aug.

Abstract

Study design: A prospective comparative study.

Purpose: To compare the incidence of unintended durotomy and return to work after open surgery versus minimally invasive spine surgery (MIS) for degenerative lumbar pathologies.

Overview of literature: The incidence of accidental durotomy varies between 0.3% and 35%. Most of these are from open surgeries, and only a handful of studies have involved the MIS approach. No single-center studies have compared open surgery with MIS, especially in the context of early return to work and dural tear (DT).

Methods: This study included 420 operated cases of degenerative lumbar pathology with a prospective follow-up of at least 6 months. Patients were divided into the open surgery and MIS groups, and the incidences of DT, early return to work, and various demographic and operative factors were compared.

Results: A total of 156 and 264 patients underwent MIS and open surgery, respectively. Incidental durotomy was documented in 52 cases (12.4%); this was significantly less in the MIS group versus the open surgery group (6.4% vs. 15.9%, p <0.05). In the open surgery group, four patients underwent revision for persistent dural leak or pseudomeningocele, but none of the cases in the MIS group had revision surgery due to DT-related complications. The incidence of DT was higher among patients with high body mass index, patients with diabetes mellitus, and patients who underwent revision surgery (p <0.05) regardless of the approach. The MIS group returned to work significantly earlier.

Conclusions: MIS was associated with a significantly lower incidence of DT and earlier return to work compared with open surgery among patients with degenerative lumbar pathology.

Keywords: Diabetes mellitus; Dural tear; Durotomy; Lumbar spine; Minimally invasive.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Postoperative magnetic resonance imaging showing pseudo-meningocele formation after open lumbar decompression.
Fig. 2
Fig. 2
Intraoperative picture showing revision suturing for a patient of persistent dural leak with pseudo-meningocele formation.
Fig. 3
Fig. 3
Postoperative magnetic resonance imaging in a case of dural tear following minimally invasive spine surgery tubular decompression.
Fig. 4
Fig. 4
Follow-up magnetic resonance imaging in a case of dural tear following minimally invasive spine surgery tubular decompression.
See this image and copyright information in PMC

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