Danger elements for incidental durotomy throughout posterior open backbone surgical procedure for degenerative illnesses in adults: A multicenter observational research.
PLoS One. 2017;12(11):e0188038
Authors: Ishikura H, Ogihara S, Oka H, Maruyama T, Inanami H, Miyoshi Ok, Matsudaira Ok, Chikuda H, Azuma S, Kawamura N, Yamakawa Ok, Hara N, Oshima Y, Morii J, Saita Ok, Tanaka S, Yamazaki T
Incidental durotomy (ID) is a typical intraoperative complication of backbone surgical procedure. It might result in persistent cerebrospinal fluid leakage, which can trigger critical problems, together with extreme headache, pseudomeningocele formation, nerve root entrapment, and intracranial hemorrhage. In consequence, it contributes to larger healthcare prices and poor affected person outcomes. The aim of this research was to make clear the impartial danger elements that may trigger ID throughout posterior open backbone surgical procedure for degenerative illnesses in adults. We carried out a potential multicenter research of grownup sufferers who underwent posterior open backbone surgical procedure for degenerative illnesses at 10 collaborating hospitals from July 2010 to June 2013. A complete of four,652 consecutive sufferers have been enrolled. We evaluated potential danger elements, together with age, intercourse, physique mass index, American Society of Anesthesiologists bodily standing classification, the presence of diabetes mellitus, using hemodialysis, smoking standing, steroid consumption, location of the surgical procedure, sort of operative process, and previous surgical historical past within the operated space. A multivariate logistic regression evaluation was carried out to establish the chance elements related to ID. The incidence of ID was eight.2% (380/four,652). Corrective vertebral osteotomy and revision surgical procedure have been recognized as impartial danger elements for ID, whereas cervical surgical procedure and discectomy have been recognized as elements that independently protected towards ID throughout posterior open backbone surgical procedure for degenerative illnesses in adults. Due to this fact, we recognized 2 impartial danger elements for and a pair of protecting elements towards ID. These outcomes could contribute to creating surgeons conscious of the chance elements for ID and can be utilized to counsel sufferers on the dangers and problems related to open backbone surgical procedure.
PMID: 29190646 [PubMed – indexed for MEDLINE]