Predisposing Factors for Dural Tear during Lumbar Spine Surgery

Abstract
Background: Dural tear is a common complication of lumbar spine surgery. The aim of this prospective study was to identify the predisposing factors for dural tear in lumbar spine surgery.
Patients and Methods: We prospectively recorded data of 174 patients with lumbar spine surgery from 2013 to 2016 in Faculty of Medicine, Bani seuf University. We compared result obtain from the patients in which a dural tear occurred (Group A) and those in which a dural tear did not occur (Group B) excluded criteria are recurrent procedures, and intradural procedures.
All the patient data like age, sex clinical examination, and scheduled procedure, and intra-operative data (surgeon experience. Type and time of surgery) were record and com-pared between the two groups.
Results: 104 patients underwent discectomy, 50 patients underwent laminectomy. And 20 patients underwent lumber fixation. Among the 104 patients who underwent discectomy 5 patients had a dural tear. Among the 50 patients who under-went laminectomy 3 patients had dural tear. Amongthe 20 patient underwent lumber fixation 2 patients had dural tear. Patients with incidental durotomy were older (mean 60±5 vs 50±5 years), and had longer surgery (180±30 vs 120±30 minutes), compared with the patients without dural tear. The incidence was significantly higher with lumber fixation (pro-longed surgery) when physician training was examined; residents were responsible for 50% of all dural tear.
Conclusion: Predisposing factors for dural tear were, older age, prolonged surgery, and the years of physician training or resident experience appear to be a major risk.