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Dural lesions in decompression for lumbar spinal stenosis: incidence, risk factors and effect on outcome.

STRÖMQVIST, FREDRIK LU ; Jönsson, Bo LU and Strömqvist, Björn LU (2012) In European Spine Journal 21(5). p.825-828
Abstract
INTRODUCTION: Decompression for lumbar spinal stenosis is one of the most frequent operations on the spine today. The most common complication seems to be a peroperative dural lesion. There are few prospective studies on this complication regarding incidence and effect on long-term outcome; this is the background for the current study. MATERIALS AND METHODS: Swespine, the Swedish Spine Register documents the majority (>80%) of lumbar spine operations in Sweden today. Within the framework of this register, totally 3,699 operations for spinal stenosis during a 5-year period were studied regarding complications and 1-year postoperative outcome. Mean patient age was 66 (37-92) years and 44% were males. Fourteen percent were smokers and 19%... (More)
INTRODUCTION: Decompression for lumbar spinal stenosis is one of the most frequent operations on the spine today. The most common complication seems to be a peroperative dural lesion. There are few prospective studies on this complication regarding incidence and effect on long-term outcome; this is the background for the current study. MATERIALS AND METHODS: Swespine, the Swedish Spine Register documents the majority (>80%) of lumbar spine operations in Sweden today. Within the framework of this register, totally 3,699 operations for spinal stenosis during a 5-year period were studied regarding complications and 1-year postoperative outcome. Mean patient age was 66 (37-92) years and 44% were males. Fourteen percent were smokers and 19% had undergone previous lumbar spine surgery. RESULTS: The overall incidence of a peroperative dural lesion was 7.4%, 8.5% of patients undergoing decompressive surgery only and 5.5% of patients undergoing decompressive surgery + fusion (p < 0.001). A logistic regression analysis demonstrated that (high) age (p < 0.0004), previous surgery (p < 0.036) and smoking (p < 0.049) were significantly predictive factors for dural lesions. An odds ratio estimate demonstrated an age-related risk increase with 2.7% per year. The risk for dural lesions also increased with number of levels decompressed. The 1-year outcome was identical in the two groups with and without a dural lesion. CONCLUSION: A dural lesion was seen in 7.4% of decompressive operations for spinal stenosis. High age, previous surgery and smoking were risk factors for sustaining a lesion, which, however, did not affect the 1-year outcome negatively. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Spine Journal
volume
21
issue
5
pages
825 - 828
publisher
Springer
external identifiers
  • wos:000303513600002
  • pmid:22146791
  • scopus:84862852414
ISSN
0940-6719
DOI
10.1007/s00586-011-2101-2
language
English
LU publication?
yes
id
4f40de89-c3a8-4e2a-bb2c-c1bbb5c12b32 (old id 2274377)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22146791?dopt=Abstract
date added to LUP
2012-01-03 13:44:43
date last changed
2017-10-29 03:19:45
@article{4f40de89-c3a8-4e2a-bb2c-c1bbb5c12b32,
  abstract     = {INTRODUCTION: Decompression for lumbar spinal stenosis is one of the most frequent operations on the spine today. The most common complication seems to be a peroperative dural lesion. There are few prospective studies on this complication regarding incidence and effect on long-term outcome; this is the background for the current study. MATERIALS AND METHODS: Swespine, the Swedish Spine Register documents the majority (&gt;80%) of lumbar spine operations in Sweden today. Within the framework of this register, totally 3,699 operations for spinal stenosis during a 5-year period were studied regarding complications and 1-year postoperative outcome. Mean patient age was 66 (37-92) years and 44% were males. Fourteen percent were smokers and 19% had undergone previous lumbar spine surgery. RESULTS: The overall incidence of a peroperative dural lesion was 7.4%, 8.5% of patients undergoing decompressive surgery only and 5.5% of patients undergoing decompressive surgery + fusion (p &lt; 0.001). A logistic regression analysis demonstrated that (high) age (p &lt; 0.0004), previous surgery (p &lt; 0.036) and smoking (p &lt; 0.049) were significantly predictive factors for dural lesions. An odds ratio estimate demonstrated an age-related risk increase with 2.7% per year. The risk for dural lesions also increased with number of levels decompressed. The 1-year outcome was identical in the two groups with and without a dural lesion. CONCLUSION: A dural lesion was seen in 7.4% of decompressive operations for spinal stenosis. High age, previous surgery and smoking were risk factors for sustaining a lesion, which, however, did not affect the 1-year outcome negatively.},
  author       = {STRÖMQVIST, FREDRIK and Jönsson, Bo and Strömqvist, Björn},
  issn         = {0940-6719},
  language     = {eng},
  number       = {5},
  pages        = {825--828},
  publisher    = {Springer},
  series       = {European Spine Journal},
  title        = {Dural lesions in decompression for lumbar spinal stenosis: incidence, risk factors and effect on outcome.},
  url          = {http://dx.doi.org/10.1007/s00586-011-2101-2},
  volume       = {21},
  year         = {2012},
}