SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020
A systematic review and meta-analysis on the management of accidental dural tears in spinal surgery: drowning in information but thirsty for a clear message.
Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Early ambulation versus prolonged bed rest for incidental durotomies in spine procedures: a systematic review and meta-analysis.Neurosurgical review · 2023Pooled it
- Dural tears from traumatic spinal fractures: an illustrative case and systematic review of its incidence, diagnosis, risk factors, and management.Journal of spine surgery (Hong Kong) · 2026Review
- Incidental durotomy in lumbar decompressive surgery: incidence and risk-factors, and the effect of durotomy on hospital and patient metrics.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- The hidden risk: Intracranial hemorrhage following durotomies in spine surgery.North American Spine Society journal · 2024Article
- Incidental Durotomy Repair in Lumbar Spine Surgery: Institutional Experience and Review of Literature.Global spine journal · 2024Article
- Incidence, Risk Factors, and Outcomes of Incidental Durotomy during Lumbar Spine Decompression with or without Fusion.Asian spine journal · 2023Article
- Dural injury following elective spine surgery - A prospective analysis of risk factors, management and complications.Journal of clinical orthopaedics and trauma · 2023Article
- Clinical management of dural defects: A review.World journal of clinical cases · 2023Review
- High efficacy of tetra-PEG hydrogel sealants for sutureless dural closure.Bioactive materials · 2022Article
- Risk Factors for Accidental Dural Tears in Spinal Surgery.International journal of spine surgery · 2021Article
- Herniation of the cauda equina into the facet joint through a pseudomeningocele: A case report and literature review.Surgical neurology international · 2021Article
- Letter to the editor concerning "A systematic review and meta-analysis on the management of accidental dural tears in spinal surgery: drowning in information but thirsty for a clear message" by Alshameeri ZAF, et al. [Eur Spine J (2020); DOI 10.1007/s00586-020-06401-y].European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020Article
- Answer to the Letter to the Editor of R. Dinesh Iyer et al. concerning "A systematic review and meta-analysis on the management of accidental dural tears in spinal surgery: drowning in information but thirsty for a clear message" by Alshameeri ZAF et al. (Eur Spine J (2020); doi: 10.1007/s00586-020-06401-y).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo systematically review the published techniques for dural tear (DT) repair in spinal surgery to determine the repair method associated with the lowest failure rate.
methodA systematic literature search was conducted. Studies reporting the treatment of accidental DT in elective spinal surgery were selected and reviewed with regards to the incidence of DT, repair techniques and outcome. Meta-analysis of proportions was used to compare the outcome of different repair techniques and their adjuncts.
resultsForty-nine studies were included with a total of 3822 DT cases. The outcome of different dural repair techniques was available for 2329(60.9%) cases. The overall pooled risk of DT was 0.052(0.040-0.065) and the overall pooled proportion of failed DT treatment regardless of the treatment method was 0.061(0.044-0.083). The proportion of failure varied according to the repair method. The overall proportion of failure following direct repair with suture (with or without any other augment) was lower than indirect repair (with sealant and or patch): 0.037 (0.024-0.053) versus 0.047 (0.026-0.074), respectively. Bed rest and the use of sub-fascial drain were not associated with improved outcome according to our results.
conclusionDirect repair was associated with low proportion of failure. Howver, the approach to DT treatment was commonly determined on an ad hoc basis according to surgeons' preferences, and few followed defined management protocols. Future studies reporting DT treatment ought to categorise the treatment outcome according to the complexity of the DT and the specific treatment used, thus improving research quality in the field.
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Registered trials
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