ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Incidental durotomy in lumbar decompressive surgery: incidence and risk-factors, and the effect of durotomy on hospital and patient metrics.
Article 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Adoption of intraoperative mechanomyography as a spinal decompression endpoint: A single-surgeon comparison by era.North American Spine Society journal · 2026Article
- Successful 10-year long-term follow-up after artificial dural patch suturing for iatrogenic dural defect created during spinal arachnoid cyst resection: a case report.International journal of surgery case reports · 2026Article
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4 authors.
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Abstract
purposeTo evaluate incidental lumbar durotomy incidence and risk-factors, and the association of durotomy with perioperative metrics and patient-reported outcomes.
methodsA total 3140 cases of 1-3 level elective decompressive surgery from 2008 to 2023 at a single centre were included. Multivariable analysis was performed on literature derived variables to identify independent risk-factors for durotomy. Absolute difference or absolute risk increase (ARI) between durotomy and non-durotomy perioperative metrics was calculated. The association between durotomy and 3-month or 12-month patient-reported outcome measures was assessed.
resultsAll-procedure durotomy incidence was 4.5% (142/3140). Durotomy risk-factors were age (odds ratio (OR) 1.016, 95% confidence intervals (95% CI) 1.011-1.020), female (OR 1.48, 95% CI 1.26-1.74), number of operative levels (two-level OR 1.81, 95% CI 1.48-2.21; three-level OR 3.18, 95% CI 2.14-4.72), multiple versus no previous operation (OR 1.85, 95% CI 1.11-3.07), and fusion with discectomy versus discectomy (OR 2.36, 95% CI 1.90-2.93). Durotomy was associated with longer length of stay (∆2.4 days, p < 0.001), longer operative time (∆21 min, p < 0.001), and higher rate of iatrogenic nerve injury (ARI 4.3%, p < 0.001), 30-day return to theatre (ARI 5.7%, p < 0.001), and 30-day readmission (ARI 4.4%, p = 0.002). Durotomy was not associated with poorer patient-reported outcomes.
conclusionDural tears are often under-reported and are associated with longer hospital stay, increased operative time, and rare perioperative complications which increase healthcare costs. Dural tears did not, however, detrimentally affect patient-reported disability or pain outcomes.
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