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European Spine Journal

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Open Access 01-03-2022 | Laminectomy | Original Article

Dural tear repair surgery comparative analysis: a stitch in time saves nine

Authors: Charles Taylor, Amad Khan, Emad Shenouda, Nicholas Brooke, Ali Nader-Sepahi

Published in: European Spine Journal | Issue 3/2022

Abstract

Purpose

A dural tear is a common iatrogenic complication of spinal surgery associated with a several post-operative adverse events. Despite their common occurrence, guidelines on how best to repair the defect remain unclear. This study uses five post-operative outcomes to the compare repair methods used to treat 106 dural tears to determine which method is clinically favourable.

Methods

Data were retrospectively collected from Southampton General Hospital’s online databases. 106 tears were identified and grouped per repair method. MANOVA was used to compare the following five outcomes: Length of stay, numbers of further admissions or revision surgeries, length of additional admissions, post-operative infection rate and dural tear associated neurological symptoms. Sub-analysis was conducted on patient demographics, primary vs non-primary closure and type of patch. Minimal clinically important difference (MCID) was calculated via the Delphi procedure.

Results

Age had a significant impact on patient outcomes and BMI displayed positive correlation with three-fifth of the predefined outcome measures. No significant difference was observed between repair groups; however, primary closure ± a patch achieved an MCID percentage improvement with regards to length of original stay, rate of additional admissions/surgeries and post-operative infection rate. Artificial over autologous patches resulted in shorter hospital stays, fewer readmissions, infections and neurological symptoms.

Conclusion

This study reports primary closure ± dural patch as the most efficient repair method with regards to the five reported outcomes. This study provides limited evidence in favour of artificial over autologous patches and recommends that dural patches be used in conjunction with primary closure.

Level of evidence I

Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

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Title: Dural tear repair surgery comparative analysis: a stitch in time saves nine
Authors: Charles Taylor
Amad Khan
Emad Shenouda
Nicholas Brooke
Ali Nader-Sepahi
Publication date: 01-03-2022
Publisher: Springer Berlin Heidelberg
Keyword: Laminectomy
Published in: European Spine Journal / Issue 3/2022
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-021-07081-y

2024 ASCO Annual Meeting

Springer Medicine

Dural tear repair surgery comparative analysis: a stitch in time saves nine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence I

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence I

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