TY - JOUR
T1 - Risk factors for dural tears
T2 - a study of elective spine surgery*
AU - Murphy, Meghan E.
AU - Kerezoudis, Panagiotis
AU - Alvi, Mohammed Ali
AU - McCutcheon, Brandon A.
AU - Maloney, Patrick R.
AU - Rinaldo, Lorenzo
AU - Shepherd, Daniel
AU - Ubl, Daniel S.
AU - Krauss, William E.
AU - Habermann, Elizabeth B.
AU - Bydon, Mohamad
N1 - Publisher Copyright:
© 2016 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Objective: This study moves beyond previous cohort studies and benchmark data by studying a population of elective spine surgery from a multicenter registry in an effort to validate, disprove, and/or identify novel risk factors for dural tears. Methods: A retrospective cohort analysis queried a multicenter registry for patients with degenerative spinal diagnoses undergoing elective spinal surgery from 2010–2014. Multivariable logistic regression analysis interrogated for independent risk factors of dural tears. Results: Of 104,930 patients, a dural tear requiring repair occurred in 0.6% of cases. On adjusted analysis, the following factors were independently associated with increased likelihood of a dural tear: ankylosing spondylitis vs. intervertebral disc disorders, greater than two levels, combined surgical approach and posterior approach vs. anterior approach, decompression only vs. fusion and decompression, age groups 85+, 75–84 and 65–74 vs. <65, obesity (BMI ≥30), corticosteroid use and preoperative platelet count <150,000. Conclusions: This multicenter study identifies novel risk factors for dural tears in the elective spine surgery population, including corticosteroids, thrombocytopenia, and ankylosing spondylitis. The results of this analysis provide further information for surgeons to use both in operative planning and in preoperative counseling when discussing the risk of dural tears.
AB - Objective: This study moves beyond previous cohort studies and benchmark data by studying a population of elective spine surgery from a multicenter registry in an effort to validate, disprove, and/or identify novel risk factors for dural tears. Methods: A retrospective cohort analysis queried a multicenter registry for patients with degenerative spinal diagnoses undergoing elective spinal surgery from 2010–2014. Multivariable logistic regression analysis interrogated for independent risk factors of dural tears. Results: Of 104,930 patients, a dural tear requiring repair occurred in 0.6% of cases. On adjusted analysis, the following factors were independently associated with increased likelihood of a dural tear: ankylosing spondylitis vs. intervertebral disc disorders, greater than two levels, combined surgical approach and posterior approach vs. anterior approach, decompression only vs. fusion and decompression, age groups 85+, 75–84 and 65–74 vs. <65, obesity (BMI ≥30), corticosteroid use and preoperative platelet count <150,000. Conclusions: This multicenter study identifies novel risk factors for dural tears in the elective spine surgery population, including corticosteroids, thrombocytopenia, and ankylosing spondylitis. The results of this analysis provide further information for surgeons to use both in operative planning and in preoperative counseling when discussing the risk of dural tears.
KW - Dural tear
KW - NSQIP
KW - degenerative spine disease
KW - elective spine surgery
KW - incidental durotomy
KW - risk factors
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UR - http://www.scopus.com/inward/citedby.url?scp=85000885236&partnerID=8YFLogxK
U2 - 10.1080/01616412.2016.1261236
DO - 10.1080/01616412.2016.1261236
M3 - Article
C2 - 27908218
AN - SCOPUS:85000885236
SN - 0161-6412
VL - 39
SP - 97
EP - 106
JO - Neurological research
JF - Neurological research
IS - 2
ER -