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Complications, pain are similar for lumbar fusion with and without incidental durotomy

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SAN FRANCISCO — Although incidental durotomy during lumbar spine fusion surgery is a common, but undesirable occurrence, investigators found that it made no difference in outcomes through the 2-year follow-up.

Owoicho Adogwa, MD, MPH, who presented the results in the study at the American Association of Neurological Surgeons Annual Meeting, noted the incidence of durotomy in the literature ranges from 1% to 7%.

“These patients continue to do well despite the fact that 4 percent of them had a durotomy,” he said.

Adogwa and colleagues selected 1,711 patients who underwent lumbar fusion for low back pain or radiculopathy in a recent 8-year period from a registry of prospectively collected data. When they retrospectively studied the patients, they found 70 patients had an incidental durotomy and 1,641 patients, who served as controls in the study, did not.

“At baseline, both cohorts of patients have significant pain and disability. At 1 year there is a significant improvement from baseline even after incidental durotomy. What is important here is no statistically significant difference in the extent of functional improvement at 1 [year] and 2 years so these patients in both cohorts improved after surgery. In conclusion, this study suggests that incidental durotomy in index spine surgery was not associated with inferior outcomes compared to a control patient cohort, or in terms of pain and function,” Adogwa said.

The outcome scores the investigators used were the patient-reported leg pain and back pain VAS scores and the Oswestry Disability Index, but they found no differences between the two groups based on outcomes measures. – by Susan M. Rapp

Reference:

Adogwa O. Paper #730. Presented at: American Association of Neurological Surgeons Annual Meeting; April 5-9, 2014; San Francisco.

Disclosure: Adogwa has no relevant financial disclosures.