A multicenter study of the presentation, treatment, and outcomes of cervical dural tears

Kevin R. O'Neill, Michael G. Fehlings, Thomas E. Mroz, Zachary A. Smith, Wellington K. Hsu, Adam S. Kanter, Michael P. Steinmetz, Paul M. Arnold, Praveen V. Mummaneni, Dean Chou, Ahmad Nassr, Sheeraz A. Qureshi, Samuel K. Cho, Evan O. Baird, Justin S. Smith, Christopher Shaffrey, Chadi A. Tannoury, Tony Tannoury, Ziya L. Gokaslan, Jeffrey L. Gum & 16 others Robert A. Hart, Robert E. Isaacs, Rick C. Sasso, David B. Bumpass, Mohamad Bydon, Mark Corriveau, Anthony F. De Giacomo, Adeeb Derakhshan, Bruce C. Jobse, Daniel Lubelski, Sungho Lee, Eric M. Massicotte, Jonathan R. Pace, Gabriel A. Smith, Khoi D. Than, K. Daniel Riew

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Study Design: Retrospective multicenter case series study. Objective: Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. Methods: Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization. Results: There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements (P <.05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears. Conclusions: In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

Original languageEnglish (US)
Pages (from-to)58S-63S
JournalGlobal Spine Journal
Volume7
Issue number1_suppl
DOIs
StatePublished - Apr 1 2017

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Tears
Multicenter Studies
Neck
Therapeutics
Reoperation
Orthopedics
Retrospective Studies
History
Demography
Organizations
Research

Keywords

  • cervical spine surgery
  • dural tears
  • patient-reported outcomes
  • surgical complications

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

O'Neill, K. R., Fehlings, M. G., Mroz, T. E., Smith, Z. A., Hsu, W. K., Kanter, A. S., ... Riew, K. D. (2017). A multicenter study of the presentation, treatment, and outcomes of cervical dural tears. Global Spine Journal, 7(1_suppl), 58S-63S. https://doi.org/10.1177/2192568216688186

A multicenter study of the presentation, treatment, and outcomes of cervical dural tears. / O'Neill, Kevin R.; Fehlings, Michael G.; Mroz, Thomas E.; Smith, Zachary A.; Hsu, Wellington K.; Kanter, Adam S.; Steinmetz, Michael P.; Arnold, Paul M.; Mummaneni, Praveen V.; Chou, Dean; Nassr, Ahmad; Qureshi, Sheeraz A.; Cho, Samuel K.; Baird, Evan O.; Smith, Justin S.; Shaffrey, Christopher; Tannoury, Chadi A.; Tannoury, Tony; Gokaslan, Ziya L.; Gum, Jeffrey L.; Hart, Robert A.; Isaacs, Robert E.; Sasso, Rick C.; Bumpass, David B.; Bydon, Mohamad; Corriveau, Mark; De Giacomo, Anthony F.; Derakhshan, Adeeb; Jobse, Bruce C.; Lubelski, Daniel; Lee, Sungho; Massicotte, Eric M.; Pace, Jonathan R.; Smith, Gabriel A.; Than, Khoi D.; Riew, K. Daniel.

In: Global Spine Journal, Vol. 7, No. 1_suppl, 01.04.2017, p. 58S-63S.

Research output: Contribution to journalArticle

O'Neill, KR, Fehlings, MG, Mroz, TE, Smith, ZA, Hsu, WK, Kanter, AS, Steinmetz, MP, Arnold, PM, Mummaneni, PV, Chou, D, Nassr, A, Qureshi, SA, Cho, SK, Baird, EO, Smith, JS, Shaffrey, C, Tannoury, CA, Tannoury, T, Gokaslan, ZL, Gum, JL, Hart, RA, Isaacs, RE, Sasso, RC, Bumpass, DB, Bydon, M, Corriveau, M, De Giacomo, AF, Derakhshan, A, Jobse, BC, Lubelski, D, Lee, S, Massicotte, EM, Pace, JR, Smith, GA, Than, KD & Riew, KD 2017, 'A multicenter study of the presentation, treatment, and outcomes of cervical dural tears', Global Spine Journal, vol. 7, no. 1_suppl, pp. 58S-63S. https://doi.org/10.1177/2192568216688186
O'Neill KR, Fehlings MG, Mroz TE, Smith ZA, Hsu WK, Kanter AS et al. A multicenter study of the presentation, treatment, and outcomes of cervical dural tears. Global Spine Journal. 2017 Apr 1;7(1_suppl):58S-63S. https://doi.org/10.1177/2192568216688186
O'Neill, Kevin R. ; Fehlings, Michael G. ; Mroz, Thomas E. ; Smith, Zachary A. ; Hsu, Wellington K. ; Kanter, Adam S. ; Steinmetz, Michael P. ; Arnold, Paul M. ; Mummaneni, Praveen V. ; Chou, Dean ; Nassr, Ahmad ; Qureshi, Sheeraz A. ; Cho, Samuel K. ; Baird, Evan O. ; Smith, Justin S. ; Shaffrey, Christopher ; Tannoury, Chadi A. ; Tannoury, Tony ; Gokaslan, Ziya L. ; Gum, Jeffrey L. ; Hart, Robert A. ; Isaacs, Robert E. ; Sasso, Rick C. ; Bumpass, David B. ; Bydon, Mohamad ; Corriveau, Mark ; De Giacomo, Anthony F. ; Derakhshan, Adeeb ; Jobse, Bruce C. ; Lubelski, Daniel ; Lee, Sungho ; Massicotte, Eric M. ; Pace, Jonathan R. ; Smith, Gabriel A. ; Than, Khoi D. ; Riew, K. Daniel. / A multicenter study of the presentation, treatment, and outcomes of cervical dural tears. In: Global Spine Journal. 2017 ; Vol. 7, No. 1_suppl. pp. 58S-63S.
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AU - Kanter, Adam S.

AU - Steinmetz, Michael P.

AU - Arnold, Paul M.

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AU - Nassr, Ahmad

AU - Qureshi, Sheeraz A.

AU - Cho, Samuel K.

AU - Baird, Evan O.

AU - Smith, Justin S.

AU - Shaffrey, Christopher

AU - Tannoury, Chadi A.

AU - Tannoury, Tony

AU - Gokaslan, Ziya L.

AU - Gum, Jeffrey L.

AU - Hart, Robert A.

AU - Isaacs, Robert E.

AU - Sasso, Rick C.

AU - Bumpass, David B.

AU - Bydon, Mohamad

AU - Corriveau, Mark

AU - De Giacomo, Anthony F.

AU - Derakhshan, Adeeb

AU - Jobse, Bruce C.

AU - Lubelski, Daniel

AU - Lee, Sungho

AU - Massicotte, Eric M.

AU - Pace, Jonathan R.

AU - Smith, Gabriel A.

AU - Than, Khoi D.

AU - Riew, K. Daniel

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KW - cervical spine surgery

KW - dural tears

KW - patient-reported outcomes

KW - surgical complications

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