Incidental durotomy should not preclude same-day discharge from lumbar spine surgery.

IF 4.9 1区医学 Q1 CLINICAL NEUROLOGY Spine Journal Pub Date : 2025-02-16 DOI:10.1016/j.spinee.2025.02.001

Austin C Kaidi, Adin Ehrlich, Tarek Harhash, Tejas Subramanian, Kasra Araghi, Prerana Katiyar, Farah Musharbash, Eric Zhao, Sereen Halayqeh, Tomoyuki Asada, Andrea Pezzi, Atahan Durbas, Adrian Lui, Oliva Tuma, Rujvee Patel, James E Dowdell, Sheeraz A Qureshi, Sravisht Iyer

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引用次数: 0

Abstract

Background context: An incidental durotomy is a common surgical complication that can occur during any spine surgery. Although rarely associated with sequelae requiring intervention, keeping patients who sustained durotomy for overnight observation is a common clinical practice.

Purpose: To determine whether patients who sustained incidental durotomy during lumbar spine surgery can be safely discharged on the day of surgery.

Design: Retrospective Cohort Study PATIENT SAMPLE: Patients who sustained incidental durotomy during elective lumbar microdiscectomy or decompression OUTCOME MEASURES: Outcome measures included complication rates, reoperation rates, readmission rates, patient reported outcome measures (PROMs) and return to activity metrics.

Methods: Over a 7-year study period, 66 patients who sustained an incidental durotomy during elective primary microdiscectomy or decompression were identified. Patients were stratified by their discharge date on either postoperative day (POD) 0 (ambulatory) or POD1-14 (inpatient). A 2-tailed students t-test was utilized to determine if there was a difference in complication rates, PROMs, or return to activity metrics.

Results: Among 66 patients who were identified, 18 were discharged on POD0 and 48 were discharged on POD1-14. Among these patients, only 27 (41%) had the durotomy repaired via primary suture repair. The vast majority utilized a combination of a dural patch and dural sealant. Overall, no significant differences were seen in complication rates, reoperation rates, readmission rates, PROMs, or return to activity metrics between the inpatient and ambulatory groups. For patients that required additional interventions for management of the durotomy, none presented within 48 hours of surgery.

Conclusion: Patients who sustain incidental durotomy during lumbar decompression/microdiscectomy can be safely discharge on the day of surgery if a watertight seal can be obtained via any repair method.

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来源期刊

Spine Journal 医学-临床神经学

CiteScore

8.20

自引率

6.70%

发文量

680

审稿时长

13.1 weeks

期刊介绍： The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.