No difference in postoperative complications, pain, and functional outcomes up to 2 years after incidental durotomy in lumbar spinal fusion: a prospective, multi-institutional, propensity-matched analysis of 1,741 patients.


Journal Article

BACKGROUND: Incidental durotomies occur in up to 17% of spinal operations. Controversy exists regarding the short- and long-term consequences of durotomies. PURPOSE: The primary aim of this study was to assess the effect of incidental durotomies on the immediate postoperative complications and patient-reported outcome measures. STUDY DESIGN: Prospective study. PATIENT SAMPLE: A total of 1,741 patients undergoing index lumbar spine fusion were selected from a multi-institutional prospective data registry. OUTCOME MEASURES: Patient-reported outcome measures used in this study included back pain (BP-Visual Analog Scale), leg pain (LP-Visual Analog Scale), and Oswestry Disability Index. METHODS: A total of 1,741 patients were selected from a multi-institutional prospective data registry, who underwent primary lumbar fusion for low back pain and/or radiculopathy between January 2003 and December 2010. We collected and analyzed data on patient demographics, postoperative complications, back pain, leg pain, and functional disability over 2 years, with risk-adjusted propensity score modeling. RESULTS: Incidental durotomies occurred in 70 patients (4%). Compared with the control group (n=1,671), there was no significant difference in postoperative infection (p=.32), need for reoperation (p=.85), or symptomatic neurologic damage (p=.66). At 1- and 2-year follow-up, there was no difference in patient-reported outcomes of back pain (BP-Visual Analog Scale), leg pain (LP-Visual Analog Scale), or functional disability (Oswestry Disability Index) (p>.3), with results remaining consistent in the propensity-matched cohort analysis (p>.4). CONCLUSION: Within the context of an on-going debate on the consequences of incidental durotomy, we found no difference in neurologic symptoms, infection, reoperation, back pain, leg pain, or functional disability over a 2-year follow-up period.

Full Text

Duke Authors

Cited Authors

  • Adogwa, O; Huang, MI; Thompson, PM; Darlington, T; Cheng, JS; Gokaslan, ZL; Gottfried, ON; Bagley, CA; Anderson, GD; Isaacs, RE

Published Date

  • September 1, 2014

Published In

Volume / Issue

  • 14 / 9

Start / End Page

  • 1828 - 1834

PubMed ID

  • 24189136

Pubmed Central ID

  • 24189136

Electronic International Standard Serial Number (EISSN)

  • 1878-1632

Digital Object Identifier (DOI)

  • 10.1016/j.spinee.2013.10.023


  • eng

Conference Location

  • United States