Does incidental durotomy affect clinical outcome in patients with lumbar degenerative diseases after posterior open lumbar interbody fusion? a multicenter observational study
Abstract Background Incidental durotomy (ID) during spinal surgery is common during spinal surgery. This study aimed to determine whether intraoperative ID affects the perioperative and long-term clinical outcomes in patients with degenerative lumbar disease (DLD) undergoing posterior open lumbar in...
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BMC
2025-04-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-025-05792-2 |
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| author | Zhendong Huan Linkai Lei |
| author_facet | Zhendong Huan Linkai Lei |
| author_sort | Zhendong Huan |
| collection | DOAJ |
| description | Abstract Background Incidental durotomy (ID) during spinal surgery is common during spinal surgery. This study aimed to determine whether intraoperative ID affects the perioperative and long-term clinical outcomes in patients with degenerative lumbar disease (DLD) undergoing posterior open lumbar interbody fusion (POLIF). Methods This multicenter observational study was conducted at two spinal centers between January 2020 and December 2022. The patients were divided into ID and non-ID groups according to whether ID occurred intraoperatively. Primary outcome measure was the length of hospital stay (LOS), while secondary outcome measures were 30-day readmission rate; hospital costs; postoperative visual analog scale (VAS) scores for low back pain (LBP) and leg pain (LP) at 1 day, 3, 7, and 15 days, 1 month, 3, 6, and 12 months; and Oswestry Disability Index (ODI) at 1 month, 3, 6, and 12 months. Results Intraoperative ID occurred in 8.7% (36/415) patients. LOS, operative time, estimated blood loss, 30-day readmission rate, and hospital costs were significantly higher in the ID group. On average, the LOS increased by 2.9 days and hospital costs increased by 4800.2 yuan per patient. The ID group had significantly higher baseline VAS scores for LBP 15 days and 1 month postoperatively than the non-ID group. The ODI was significantly higher in the ID group than in the non-ID group 1 month postoperatively. No significant differences were noted in the VAS scores and ODI between the two groups at 3, 6, and 12 months postoperatively. Finally, we found that a higher BMI (P = 0.035, OR: 1.195, 95%CI: 1.012–1.412) and revision surgery (P = 0.022, OR: 2.901, 95%CI: 1.164–7.233) were risk factors for intraoperative ID. Conclusions Although ID does not significantly affect the long-term outcomes in patients with DLD after POLIF, it can lead to poorer perioperative clinical outcomes. Lumbar fusion surgery should be performed meticulously to minimize the incidence of intraoperative ID. |
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| language | English |
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| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-2afa6b30706e48f3a6a12b5f29dbd9362025-08-20T02:17:56ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-04-012011910.1186/s13018-025-05792-2Does incidental durotomy affect clinical outcome in patients with lumbar degenerative diseases after posterior open lumbar interbody fusion? a multicenter observational studyZhendong Huan0Linkai Lei1Department of Trauma Orthopedics, Yantai Yuhuangding Hospital Affiliated to Qingdao UniversityDepartment of Spine Surgery, Yantaishan HospitalAbstract Background Incidental durotomy (ID) during spinal surgery is common during spinal surgery. This study aimed to determine whether intraoperative ID affects the perioperative and long-term clinical outcomes in patients with degenerative lumbar disease (DLD) undergoing posterior open lumbar interbody fusion (POLIF). Methods This multicenter observational study was conducted at two spinal centers between January 2020 and December 2022. The patients were divided into ID and non-ID groups according to whether ID occurred intraoperatively. Primary outcome measure was the length of hospital stay (LOS), while secondary outcome measures were 30-day readmission rate; hospital costs; postoperative visual analog scale (VAS) scores for low back pain (LBP) and leg pain (LP) at 1 day, 3, 7, and 15 days, 1 month, 3, 6, and 12 months; and Oswestry Disability Index (ODI) at 1 month, 3, 6, and 12 months. Results Intraoperative ID occurred in 8.7% (36/415) patients. LOS, operative time, estimated blood loss, 30-day readmission rate, and hospital costs were significantly higher in the ID group. On average, the LOS increased by 2.9 days and hospital costs increased by 4800.2 yuan per patient. The ID group had significantly higher baseline VAS scores for LBP 15 days and 1 month postoperatively than the non-ID group. The ODI was significantly higher in the ID group than in the non-ID group 1 month postoperatively. No significant differences were noted in the VAS scores and ODI between the two groups at 3, 6, and 12 months postoperatively. Finally, we found that a higher BMI (P = 0.035, OR: 1.195, 95%CI: 1.012–1.412) and revision surgery (P = 0.022, OR: 2.901, 95%CI: 1.164–7.233) were risk factors for intraoperative ID. Conclusions Although ID does not significantly affect the long-term outcomes in patients with DLD after POLIF, it can lead to poorer perioperative clinical outcomes. Lumbar fusion surgery should be performed meticulously to minimize the incidence of intraoperative ID.https://doi.org/10.1186/s13018-025-05792-2Degenerative lumbar diseasesPosterior open lumbar interbody fusionIncidental durotomyClinical outcomesRisk factor |
| spellingShingle | Zhendong Huan Linkai Lei Does incidental durotomy affect clinical outcome in patients with lumbar degenerative diseases after posterior open lumbar interbody fusion? a multicenter observational study Journal of Orthopaedic Surgery and Research Degenerative lumbar diseases Posterior open lumbar interbody fusion Incidental durotomy Clinical outcomes Risk factor |
| title | Does incidental durotomy affect clinical outcome in patients with lumbar degenerative diseases after posterior open lumbar interbody fusion? a multicenter observational study |
| title_full | Does incidental durotomy affect clinical outcome in patients with lumbar degenerative diseases after posterior open lumbar interbody fusion? a multicenter observational study |
| title_fullStr | Does incidental durotomy affect clinical outcome in patients with lumbar degenerative diseases after posterior open lumbar interbody fusion? a multicenter observational study |
| title_full_unstemmed | Does incidental durotomy affect clinical outcome in patients with lumbar degenerative diseases after posterior open lumbar interbody fusion? a multicenter observational study |
| title_short | Does incidental durotomy affect clinical outcome in patients with lumbar degenerative diseases after posterior open lumbar interbody fusion? a multicenter observational study |
| title_sort | does incidental durotomy affect clinical outcome in patients with lumbar degenerative diseases after posterior open lumbar interbody fusion a multicenter observational study |
| topic | Degenerative lumbar diseases Posterior open lumbar interbody fusion Incidental durotomy Clinical outcomes Risk factor |
| url | https://doi.org/10.1186/s13018-025-05792-2 |
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