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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: Analysis of the Lumbar Spinal Outcome Study (LSOS) data – A prospective multi-center cohort study

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  • Nils H. Ulrich - Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, Zurich, Switzerland
  • Jakob M. Burgstaller - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Switzerland
  • Mazda Farshad - Department of Orthopedics, University Hospital Balgrist, University of Zurich, Switzerland
  • Johann Steurer - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Switzerland
  • Ulrike Held - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Switzerland
  • François Porchet - Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, Zurich, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocP 112

doi: 10.3205/16dgnc487, urn:nbn:de:0183-16dgnc4871

Published: June 8, 2016

© 2016 Ulrich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Incidental durotomy is a well-known complication during surgery for degenerative lumbar spinal stenosis (DLSS). In this prospective multicenter cohort study including eight medical centers our aim was to assess whether incidental durotomy during first-time lumbar spinal stenosis decompression surgery without fusion has an impact on long-term outcome.

Method: Patients of the multi-center Lumbar Stenosis Outcome Study (LSOS) with confirmed DLSS undergoing first-time decompression without fusion were enrolled in this study. Baseline patient characteristics and outcomes were analyzed at 6, 12, and 24 months follow-up respectively with the Spinal Stenosis Measure (SSM), the Numeric Rating Scale (NRS), Feeling Thermometer (FT), the EQ-5D-EL, and the Roland and Morris Disability Questionnaire (RMDQ).

Results: A total of 167 patients met the inclusion criteria. Fifteen (9%) of those patients had an incidental durotomy. Baseline characteristics were similar between the durotomy and no-durotomy group. All patients improved over time. In the group of durotomy patients, the median improvement in SSM symptoms scale was 1.1 points at 6 months, 1.1 points at 12 months, and 1.6 points at 24 months after baseline. For the no-durotomy group, these improvements were 0.8, 0.9, and 0.9. For SSM function the improvements were 1.0, 0.8, and 0.9 in the durotomy group, and 0.6, 0.8, and 0.8 in the no-durotomy group. None of the between-group differences were statistically significant.

Conclusions: Incidental durotomy in patients with DLSS undergoing first-time decompression surgery without fusion did not have negative effect on long-term outcome and quality of life.