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RESEARCH PRODUCT
Risk factors for incidental durotomy during posterior open spine surgery for degenerative diseases in adults: A multicenter observational study.
Takashi YamazakiJiro MoriiYasushi OshimaKo MatsudairaKiyofumi YamakawaHirotaka ChikudaHiroyuki OkaToru MaruyamaHisatoshi IshikuraSakae TanakaSatoshi OgiharaKota MiyoshiHirohiko InanamiNobuhiro HaraKazuo SaitaNaohiro KawamuraSeiichi Azumasubject
MaleMedical DoctorsPhysiologymedicine.medical_treatmentHealth Care Providerslcsh:MedicinePathology and Laboratory MedicineDegenerative DiseasesBody Mass Index0302 clinical medicineMathematical and Statistical TechniquesEndocrinologyRisk FactorsMedicine and Health SciencesProspective StudiesMedical PersonnelProspective cohort studyIntraoperative Complicationslcsh:ScienceMusculoskeletal System030222 orthopedicsMultidisciplinaryLumbar VertebraeIncidence (epidemiology)Neurodegenerative DiseasesMiddle AgedPseudomeningoceleProfessionsmedicine.anatomical_structurePhysiological ParametersPhysical SciencesRegression AnalysisFemaleAnatomyStatistics (Mathematics)Research Articlemedicine.medical_specialtyIntraoperative ComplicationEndocrine DisordersSurgical and Invasive Medical ProceduresLumbar vertebraeResearch and Analysis Methods03 medical and health sciencesDiscectomyPhysiciansmedicineDiabetes MellitusHumansStatistical MethodsAgedSurgeonsbusiness.industryBody Weightlcsh:RBiology and Life SciencesHealth Risk AnalysisSpineSurgeryHealth CareMetabolic DisordersPeople and PlacesObservational studyPopulation Groupingslcsh:QDura MaterbusinessBody mass index030217 neurology & neurosurgeryMathematicsdescription
Incidental durotomy (ID) is a common intraoperative complication of spine surgery. It can lead to persistent cerebrospinal fluid leakage, which may cause serious complications, including severe headache, pseudomeningocele formation, nerve root entrapment, and intracranial hemorrhage. As a result, it contributes to higher healthcare costs and poor patient outcomes. The purpose of this study was to clarify the independent risk factors that can cause ID during posterior open spine surgery for degenerative diseases in adults. We conducted a prospective multicenter study of adult patients who underwent posterior open spine surgery for degenerative diseases at 10 participating hospitals from July 2010 to June 2013. A total of 4,652 consecutive patients were enrolled. We evaluated potential risk factors, including age, sex, body mass index, American Society of Anesthesiologists physical status classification, the presence of diabetes mellitus, the use of hemodialysis, smoking status, steroid intake, location of the surgery, type of operative procedure, and past surgical history in the operated area. A multivariate logistic regression analysis was performed to identify the risk factors associated with ID. The incidence of ID was 8.2% (380/4,652). Corrective vertebral osteotomy and revision surgery were identified as independent risk factors for ID, while cervical surgery and discectomy were identified as factors that independently protected against ID during posterior open spine surgery for degenerative diseases in adults. Therefore, we identified 2 independent risk factors for and 2 protective factors against ID. These results may contribute to making surgeons aware of the risk factors for ID and can be used to counsel patients on the risks and complications associated with open spine surgery.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2017-11-30 | PLoS ONE |