Durotomy is associated with pseudoarthrosis following lumbar fusion

Mohamad Bydon, Rafael De La Garza-Ramos, Nicholas B. Abt, Mohamed Macki, Daniel M. Sciubba, Jean Paul Wolinsky, Ali Bydon, Ziya L. Gokaslan, Timothy F. Witham

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Pseudoarthrosis is a known complication following lumbar fusion, and although several risk factors have been established, the association of durotomy and pseudoarthrosis has not been studied to our knowledge. A retrospective review was performed to identify all adult patients who underwent lumbar posterolateral fusion (without interbody fusion) for degenerative spine disease over a 20 year period at a single institution. Patients were divided into durotomy and no durotomy cohorts. Patients were included if they had at least 1 year of follow-up. The main outcome variable was development of pseudoarthrosis. A total of 327 patients were identified, of whom 17 (5.19%) had a durotomy. Pseudoarthrosis rates were significantly higher in the durotomy group (35.29%) when compared to the no durotomy group (13.87%), with the difference being statistically significant (p = 0.016). Univariate analysis revealed that durotomy (p = 0.003) and the number of levels fused (p = 0.015) were the only two significant risk factors for pseudoarthrosis. After controlling for the number of levels fused, the adjusted relative risk (RR) revealed that patients with a durotomy were 2.23 times more likely to develop pseudoarthrosis (RR 2.23; 95% confidence interval 1.05-4.75) when compared to patients without durotomy. The findings in the present study suggest an association between durotomy and pseudoarthrosis development. Patients with a durotomy were 2.2 times more likely to develop pseudoarthrosis compared to patients without a durotomy. Future and larger studies are required to corroborate our findings.

Original languageEnglish (US)
Pages (from-to)544-548
Number of pages5
JournalJournal of Clinical Neuroscience
Volume22
Issue number3
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

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Pseudarthrosis
Spine
Confidence Intervals

Keywords

  • Cerebrospinal fluid leak
  • Complications
  • Degenerative spine disease
  • Fusion
  • Instrumentation
  • Lumbar
  • Pseudoarthrosis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Bydon, M., De La Garza-Ramos, R., Abt, N. B., Macki, M., Sciubba, D. M., Wolinsky, J. P., ... Witham, T. F. (2015). Durotomy is associated with pseudoarthrosis following lumbar fusion. Journal of Clinical Neuroscience, 22(3), 544-548. https://doi.org/10.1016/j.jocn.2014.08.023

Durotomy is associated with pseudoarthrosis following lumbar fusion. / Bydon, Mohamad; De La Garza-Ramos, Rafael; Abt, Nicholas B.; Macki, Mohamed; Sciubba, Daniel M.; Wolinsky, Jean Paul; Bydon, Ali; Gokaslan, Ziya L.; Witham, Timothy F.

In: Journal of Clinical Neuroscience, Vol. 22, No. 3, 01.03.2015, p. 544-548.

Research output: Contribution to journalArticle

Bydon, M, De La Garza-Ramos, R, Abt, NB, Macki, M, Sciubba, DM, Wolinsky, JP, Bydon, A, Gokaslan, ZL & Witham, TF 2015, 'Durotomy is associated with pseudoarthrosis following lumbar fusion', Journal of Clinical Neuroscience, vol. 22, no. 3, pp. 544-548. https://doi.org/10.1016/j.jocn.2014.08.023
Bydon M, De La Garza-Ramos R, Abt NB, Macki M, Sciubba DM, Wolinsky JP et al. Durotomy is associated with pseudoarthrosis following lumbar fusion. Journal of Clinical Neuroscience. 2015 Mar 1;22(3):544-548. https://doi.org/10.1016/j.jocn.2014.08.023
Bydon, Mohamad ; De La Garza-Ramos, Rafael ; Abt, Nicholas B. ; Macki, Mohamed ; Sciubba, Daniel M. ; Wolinsky, Jean Paul ; Bydon, Ali ; Gokaslan, Ziya L. ; Witham, Timothy F. / Durotomy is associated with pseudoarthrosis following lumbar fusion. In: Journal of Clinical Neuroscience. 2015 ; Vol. 22, No. 3. pp. 544-548.
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abstract = "Pseudoarthrosis is a known complication following lumbar fusion, and although several risk factors have been established, the association of durotomy and pseudoarthrosis has not been studied to our knowledge. A retrospective review was performed to identify all adult patients who underwent lumbar posterolateral fusion (without interbody fusion) for degenerative spine disease over a 20 year period at a single institution. Patients were divided into durotomy and no durotomy cohorts. Patients were included if they had at least 1 year of follow-up. The main outcome variable was development of pseudoarthrosis. A total of 327 patients were identified, of whom 17 (5.19{\%}) had a durotomy. Pseudoarthrosis rates were significantly higher in the durotomy group (35.29{\%}) when compared to the no durotomy group (13.87{\%}), with the difference being statistically significant (p = 0.016). Univariate analysis revealed that durotomy (p = 0.003) and the number of levels fused (p = 0.015) were the only two significant risk factors for pseudoarthrosis. After controlling for the number of levels fused, the adjusted relative risk (RR) revealed that patients with a durotomy were 2.23 times more likely to develop pseudoarthrosis (RR 2.23; 95{\%} confidence interval 1.05-4.75) when compared to patients without durotomy. The findings in the present study suggest an association between durotomy and pseudoarthrosis development. Patients with a durotomy were 2.2 times more likely to develop pseudoarthrosis compared to patients without a durotomy. Future and larger studies are required to corroborate our findings.",
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AU - De La Garza-Ramos, Rafael

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AU - Sciubba, Daniel M.

AU - Wolinsky, Jean Paul

AU - Bydon, Ali

AU - Gokaslan, Ziya L.

AU - Witham, Timothy F.

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AB - Pseudoarthrosis is a known complication following lumbar fusion, and although several risk factors have been established, the association of durotomy and pseudoarthrosis has not been studied to our knowledge. A retrospective review was performed to identify all adult patients who underwent lumbar posterolateral fusion (without interbody fusion) for degenerative spine disease over a 20 year period at a single institution. Patients were divided into durotomy and no durotomy cohorts. Patients were included if they had at least 1 year of follow-up. The main outcome variable was development of pseudoarthrosis. A total of 327 patients were identified, of whom 17 (5.19%) had a durotomy. Pseudoarthrosis rates were significantly higher in the durotomy group (35.29%) when compared to the no durotomy group (13.87%), with the difference being statistically significant (p = 0.016). Univariate analysis revealed that durotomy (p = 0.003) and the number of levels fused (p = 0.015) were the only two significant risk factors for pseudoarthrosis. After controlling for the number of levels fused, the adjusted relative risk (RR) revealed that patients with a durotomy were 2.23 times more likely to develop pseudoarthrosis (RR 2.23; 95% confidence interval 1.05-4.75) when compared to patients without durotomy. The findings in the present study suggest an association between durotomy and pseudoarthrosis development. Patients with a durotomy were 2.2 times more likely to develop pseudoarthrosis compared to patients without a durotomy. Future and larger studies are required to corroborate our findings.

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KW - Instrumentation

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