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Comparative Study
. 2025 Jan;34(1):295-300.
doi: 10.1007/s00586-024-08503-3. Epub 2024 Oct 14.

Open vs tubular rate of re-operation for incidental durotomies after lumbar microdiscectomies: a propensity matched analysis

Edward McClain  1 , Bhavika Gupta  1 , Lauren Zane  1 , Joel DeFelice  2 , Cody Woodhouse  3 , Jenna Li  1 , Dallas E Kramer  1 , Shahed Elhamdani  1 , Daniel Myers  1 , Chen Xu  1 , Alexander Yu  1
Affiliations
Comparative Study

Open vs tubular rate of re-operation for incidental durotomies after lumbar microdiscectomies: a propensity matched analysis

Edward McClain et al. Eur Spine J. 2025 Jan.

Abstract

Purpose: Incidental durotomy (ID) is a common complication in spine surgery and can lead to increase in length of stay, decreased satisfaction with surgery and pseudomeningocele formation. Here, we describe a retrospective study comparing ID occurrences and repairs between patients receiving traditional open versus tubular minimally invasive spine (MIS) microdiscectomy.

Methods: A retrospective comparative cohort-matched analysis was performed to study ID and its complications in MIS versus open lumbar microdiscectomies. The study included 192 patients in the tubular MIS cohort and 2902 patients in the open microdiscectomy cohort. Propensity scores were estimated by age and Elixhauser comorbidity score. After cohort matching, 156 patients were included in the open cohort. The difference in proportion for incidental durotomies, re-operation for pseudomeningocele, and levels were calculated using a Fisher's exact test.

Results: The total incidence of durotomy in our cohort of 348 patients was 3.1% (n = 11), 5 (3.2%) in the open cohort and 6 (3.1%) in the tubular cohort. Various ID repair techniques were used including primary repair and dural sealants. One patient in the open cohort required re-operation for pseudomeningocele formation while none required re-operation in the MIS cohort. This result was not significant (p = 0.45).

Conclusion: Pseudomeningocele formation after ID is rare. The rates of ID were similar between cohorts. We found no significant difference between re-operation rate for pseudomeningocele between the two cohorts. Larger, cohort-matched, prospective studies are needed to determine the true difference between rates of re-operation for pseudomeningocele formation after lumbar microdiscectomies.

Keywords: Incidental durotomy; MIS; Microdiscectomies; Pseudomeningocele.

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Conflict of interest statement

Declarations. Conflicts of interest: The authors have no conflicts of interest or any financial disclosures related to this topic. Appropriate Institutional Review Board (IRB) approval was obtained for this study.

References

    1. Swanson HS, Fincher EF (1947) Extradural arachnoidal cysts of traumatic origin. J Neurosurg 4(6):530–538. https://doi.org/10.3171/jns.1947.4.6.0530
    1. Raudenbush BL, Molinari A, Molinari RW (2017) Large compressive pseudomeningocele causing early major neurologic deficit after spinal surgery. Global Spine J 7(3):206–212. https://doi.org/10.1177/2192568217694145 - DOI - PubMed - PMC
    1. Cammisa FP, Jr, Girardi FP, Sangani PK, Parvataneni HK, Cadag S, Sandhu HS (2000) Incidental durotomy in spine surgery. Spine 25(20):2663–2667. https://doi.org/10.1097/00007632-200010150-00019 - DOI - PubMed
    1. Wang JC, Bohlman HH, Riew KD (1998) Dural tears secondary to operations on the lumbar spine. Management and results after a two-year-minimum follow-up of eighty-eight patients. J Bone Joint Surg Am Vol 80(12):1728–1732. https://doi.org/10.2106/00004623-199812000-00002 - DOI
    1. Kogias E, Klingler JH, Jimenez F, Vasilikos P, Sircar I, Scholz R, C., Hubbe U (2017) Incidental durotomy in Open Versus Tubular Revision Microdiscectomy: a retrospective controlled study on incidence, management, and Outcome. Clin Spine Surg 30(10):E1333–E1337. https://doi.org/10.1097/BSD.0000000000000279 - DOI - PubMed

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