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Unintended dural tears during unilateral biportal endoscopic lumbar surgery: incidence and risk factors – Lumbar Spinal Stenosis

The article in Acta Neurochir (Wien) discusses the incidence and risk factors of unintended dural tears (DT) in patients undergoing unilateral biportal endoscopic (UBE) lumbar spine surgery for degenerative diseases. The study found that 3.95% of patients experienced DTs, with older age, lumbar spinal stenosis (LSS), unilateral laminotomy with bilateral decompression (ULBD), and revision surgery being significant risk factors for DT. Although DTs were successfully treated with primary suture repair or bed rest, no serious postoperative complications occurred. The study highlights the importance of identifying and managing risk factors to reduce the incidence of DT in UBE surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spine hospital in UK

Published article

CONCLUSIONS: In this UBE cohort, we found that the incidence of DT was 3.95%. Additionally, older age, LSS, ULBD, and revision surgery significantly increased the risk of DT in UBE surgery.

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Acta Neurochir (Wien). 2024 Feb 21;166(1):95. doi: 10.1007/s00701-024-05965-8.ABSTRACTBACKGROUND: An unintended dural tear (DT) is the most common intraoperative complication of lumbar spine surgery. The unilateral biportal endoscopic technique (UBE) has become increasingly popular for treating various degenerative diseases of the lumbar spine; however, the DT incidence and risk factors specific to UBE remain undetermined. Therefore,

Acta Neurochir (Wien). 2024 Feb 21;166(1):95. doi: 10.1007/s00701-024-05965-8.

ABSTRACT

BACKGROUND: An unintended dural tear (DT) is the most common intraoperative complication of lumbar spine surgery. The unilateral biportal endoscopic technique (UBE) has become increasingly popular for treating various degenerative diseases of the lumbar spine; however, the DT incidence and risk factors specific to UBE remain undetermined. Therefore, this study aimed to evaluate the incidence and risk factors of DTs in UBE.

METHOD: Data from all patients who underwent UBE for degenerative lumbar spinal diseases from November 2018 to December 2021 at our institution were used to assess the effects of demographics, diagnosis, and type of surgery on unintended DT risk.

RESULTS: Overall, 24/608 patients (3.95%) experienced DTs and were treated with primary suture repair or bed rest. Although several patients experienced mild symptoms of cerebrospinal fluid (CSF) leaks, no serious postoperative sequelae such as nerve root entrapment, meningitis, or intracranial hemorrhage occurred. Additionally, no significant correlations were identified between DT and sex (P = 0.882), body mass index (BMI) (P = 0.758), smoking status (P = 0.506), diabetes (P = 0.672), hypertension (P = 0.187), or surgeon experience (P = 0.442). However, older patients were more likely to experience DT than younger patients (P = 0.034), and patients with lumbar spinal stenosis (LSS) were more likely to experience DT than patients with lumbar disc herniation (LDH) (P = 0.035). Additionally, DT was more common in revision versus primary surgery (P < 0.0001) and in unilateral laminotomy with bilateral decompression (ULBD) versus unilateral decompression (P = 0.031). Univariate logistic regression analysis revealed that age, LSS, ULBD, and revision surgery were significant risk factors for DT.

CONCLUSIONS: In this UBE cohort, we found that the incidence of DT was 3.95%. Additionally, older age, LSS, ULBD, and revision surgery significantly increased the risk of DT in UBE surgery.

PMID:38381267 | DOI:10.1007/s00701-024-05965-8

The London Spine Unit : best recognised spine hospital in UK

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Unintended dural tears during unilateral biportal endoscopic lumbar surgery: incidence and risk factors

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Acta Neurochir (Wien). 2024 Feb 21;166(1):95. doi: 10.1007/s00701-024-05965-8.ABSTRACTBACKGROUND: An unintended dural tear (DT) is the most common intraoperative complication of lumbar spine surgery. The unilateral biportal endoscopic technique (UBE) has become increasingly popular for treating various degenerative diseases of the lumbar spine; however, the DT incidence and risk factors specific to UBE remain undetermined. Therefore

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