Threat components for incidental durotomy throughout posterior open backbone surgical procedure for degenerative ailments in adults: A multicenter observational research.
PLoS One. 2017;12(11):e0188038
Authors: Ishikura H, Ogihara S, Oka H, Maruyama T, Inanami H, Miyoshi Okay, Matsudaira Okay, Chikuda H, Azuma S, Kawamura N, Yamakawa Okay, Hara N, Oshima Y, Morii J, Saita Okay, Tanaka S, Yamazaki T
Incidental durotomy (ID) is a typical intraoperative complication of backbone surgical procedure. It could possibly result in persistent cerebrospinal fluid leakage, which can trigger critical issues, together with extreme headache, pseudomeningocele formation, nerve root entrapment, and intracranial hemorrhage. Consequently, it contributes to greater healthcare prices and poor affected person outcomes. The aim of this research was to make clear the unbiased threat components that may trigger ID throughout posterior open backbone surgical procedure for degenerative ailments in adults. We performed a potential multicenter research of grownup sufferers who underwent posterior open backbone surgical procedure for degenerative ailments at 10 collaborating hospitals from July 2010 to June 2013. A complete of four,652 consecutive sufferers had been enrolled. We evaluated potential threat components, 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 danger components related to ID. The incidence of ID was eight.2% (380/four,652). Corrective vertebral osteotomy and revision surgical procedure had been recognized as unbiased threat components for ID, whereas cervical surgical procedure and discectomy had been recognized as components that independently protected in opposition to ID throughout posterior open backbone surgical procedure for degenerative ailments in adults. Due to this fact, we recognized 2 unbiased threat components for and a pair of protecting components in opposition to ID. These outcomes might contribute to creating surgeons conscious of the danger components for ID and can be utilized to counsel sufferers on the dangers and issues related to open backbone surgical procedure.
PMID: 29190646 [PubMed – indexed for MEDLINE]