Introduction
Methods
Patient Number | Department | Age | BMI | Procedure | Length of stay | Dural complication | Method of repair | Symptoms post repair | Infection post repair | Readmissions | Readmission procedures | Duration of readmissions |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Neuro | 42 | 27.17 | L5/S1 microdiscectomy | 3 | Small dural puncture and Psudomeningocoele | 5.0 Vicryl, duraseal, 6.0 Prolene, tissue dural patch and lumbar drain | Fluid collection, sciatica, back and leg pain, headache and low-pressure symptoms | None | 2 | Dural tear repair | 9 |
2 | Neuro | 70 | 28.73 | Laminectomy, fusion and fixation for L3-4 instability with radiculopathy | 5 | CSF Leak whilst drilling the pars/facet complex | 5/0 Vicryl, Tisseel glue and muscle patch | Back pain | None | 1 | None | 4 |
3 | Neuro | 48 | L4/L5 decompression and microdiscectomy | CSF leak /lumbar pseudmeningocele and persistent CSF fistula | Lumbar drain, 5.0 Prolene, muscle patch, fat graft and duraseal | Back and leg pain, pins and needles, L5 distribution numbness | Yes | 2 | Revision of lumbar wound and washout | 43 | ||
4 | Neuro | 38 | 34.26 | Microdiscectomy for L5-S1 lateral disc prolapse | 2 | Post-operative CSF leak and pseudomeningocele | Lumbar drain, fat graft and Tisseel | Occasional pain or tingling in lateral 3 toes of left foot | None | 1 | Repair of pseudomeningocele, re-do microdiscectomy and insertion of lumbar drain | 7 |
5 | Neuro | 54 | 42.19 | L4/L5 decompression | 3 | Post-operative CSF leak and pseudomeningocele | 5/0 Prolene muscle patch and Tisseel | Sudden onset headache and photophobia | None | 1 | Repair of dural tear | 7 |
6 | Neuro | 45 | 26.03 | C5/6 ACDF and bilateral foraminotomy | 5 | Intra-op dural tear with CSF leak | Micro patty, muscle patch and Tisseel | Headaches, right arm pain, burning sensation and hypersensitivity | None | 0 | 0 | |
7 | Neuro | 48 | 20.23 | L4/L5 laminectomy and discectomy | 2 | Dural tear due to blunt instruments | Primary repair failed. Patch of fascia, durogen patch and Tisseel glue | Headaches and mild wound swelling | None | 1 | Repair of lumbar pseudomeningocele | 3 |
8 | Neuro | 28 | 32.98 | Cervical Intramedullary Ependymoma | 4 | CSF leak requiring lumbar drain | Lumbar drain | Complete numbness in band around trunk and numb abdomen. Reduced bladder sensation. Keloid scar | None | 1 | Lumbar drain insertion | 10 |
9 | Neuro | 58 | 24.87 | Midline Primary anterior cervical decompression | 2 | Intra-op dural tear with CSF leak | flowseal, spongistan. Tisseel | Residual weakness in left hand | None | 0 | 0 | |
10 | Neuro | 42 | Large inferior central disc taken out in 3 large fragments (L5/S1) | 7 | Two pinhole tears made to the dura with CSF leak | 5.0 Prolene and tissue patch | Weakness of left leg calf muscles and reduced toe-off. Numb saddle region. Plantar flexion weakness | None | 0 | 0 | ||
11 | Neuro | 50 | 29.35 | L4/5 decompression and L4/5 discectomy for Cauda Equina Compression | 3 | Dural tear and CSF leak noticed post-operatively in relation to a bony spur | 5/0 Vicryl, muscle, Tisseel and lumbar drain | Headaches, lower back pain, wound swelling | None | 1 | Insertion of Lumbar drain, wound exploration and re-do microdiscectomy | 6 |
12 | Neuro | 74 | Laminectomy for L4/5 stenosis | 3 | Intraoperative dural tear with CSF leak on and pseudomeningocele | 5.0 Vicryl sutures and tissue dura patch | Intermittent pain in both legs | None | 1 | None | 8 | |
13 | Neuro | 77 | 29.00 | L3/L4 decompression and laminectomy for spinal stenosis | 12 | Small dural tear and CSF leak from wound | Tissue patch Vicryl suture, 6/0 Prolene, Surgical, floseal and Tisseel glue | Trifascicular block and bradycardia | None | 1 | Repair of CSF leak | 0 |
14 | Neuro | 37 | 37.60 | Re-exploration of L5 nerve root | 8 | Intraoperative dural tear requiring further surgery | Dural glue, stitches, 5/0 Vicryl, muscle patch, Tisseel and lumbar drain | Positional headaches, worsening pain, soft/fluctuant swelling at lumbar site, large pseudomeningocele | Yes | 1 | Repair of pseudomeningocele and lumbar drain insertion | 7 |
15 | Neuro | 59 | 31.51 | L3/L4 decompressive laminectomy | 5 | Adherent thickened ligamentum flavum causing dural tear | Primary repair and muscle graft | Continued numbness in right leg, shooting pain bilaterally, L4 nerve root irritation and mechanical lower back pain | None | 0 | 0 | |
16 | Neuro | 68 | 24.94 | Laminectomy at L3/4 and L4/5 | 6 | L3/L4 dural tear | Bioglue | Occasional pain down the back of the leg and back | Yes | 0 | 0 | |
17 | Neuro | 47 | L5 laminectomy and L5/S1 discectomy | 8 | Small dural tear below L5 | 5–0 Prolene, tissupath and bioglue | Numbness in left side of genital area through to buttock. Pins and needles in left buttock | None | 0 | 0 | ||
18 | Neuro | 74 | 26.79 | L3/4, L4/5 decompression and L4 laminectomy | 5 | ligamentum flavum adherent to dura | 6.0 Vicryl and tissue patch | Constant stinging painful sensation in feet, ankles and shins, hypersensitivity to light touch | None | 0 | 0 | |
19 | Neuro | 67 | 23.24 | L4/L5 intersegmental decompression | 4 | Intraoperative dural tear with a CSF leak | 6/0 Prolene and tissue patch | Severe sciatica from the buttock to the Achilles area | None | 0 | 0 | |
20 | Neuro | 77 | 27.66 | L3-S1 posterior lateral fusion, L3/4, L4/5, L5/S1 TLIF | 11 | Dural tear and 3.1 L blood loss | Dura tissue patch, lumbar drain and 5–0 Prolene | None | None | 0 | 0 | |
21 | Neuro | 52 | 29.55 | L4/5 intersegmental decompression | 5 | Two small dural tears at inferior edge | 7–0 Prolene sutures and tissue patch | None | None | 0 | 0 | |
22 | Neuro | 69 | 43.07 | L4/L5 posterior lumbar interbody fusion and decompression | 6 | Small dural tear intraoperatively on right side | Tissue patch dura, Duraseal and Flowseal | Back pain and right-sided sciatica | None | 0 | 0 | |
23 | Neuro | 22 | 33.56 | Revision of paddle SCS and insertion of Surpass Electrode | 4 | Dura stuck to bone. Dural tear was seen in 3 places | Tissue Dura and Adherus | Multiple back pain symptoms and complications | Yes | 1 | None | 5 |
24 | Neuro | 74 | 31.20 | L3/L4 Decompression and Discectomy | 3 | Dural tear observed on closure | Subfascial drain | None | None | 0 | 0 | |
25 | Neuro | 46 | 27.86 | T10/T11 Decompression and posterior instrumented fusion | 10 | Dural tear observed on closure | Muscle graft, duraseal and subfascial drain | Patient was unable to move his legs | Yes | 0 | 0 | |
26 | Neuro | 51 | 22.10 | C7/T1 ACDF and plate stabilisation | 3 | Dural tear sustained | Duraseal | None | None | 0 | 0 | |
27 | Neuro | 44 | 20.13 | Removal of posterior lumbar spine instrumentation | 3 | Small longitudinal dural tear adjacent to midline below S1 | 6–0 Prolene, duragen, durasel, surgical patty and lumbar drain | None | None | 0 | 0 | |
28 | Neuro | 38 | 27.14 | Urgent L5-S1 decompression and microdiscectomy | 4 | Intraoperative dural tear following dissection of the ligamentum flavum | Vicryl 5–0 and Tisseel | Problems with bowel control as well as altered saddle region sensation and sexual dysfunction | None | 0 | 0 | |
29 | Neuro | 47 | 28.18 | L4/L5 discectomy | 20 | Two intraoperative dural tears | Vicryl 5/0, Floseal and Tisseel | Persistent lower back pain and neuropathic pain on the right leg | None | 0 | 0 | |
30 | Neuro | 56 | C4/C5 anterior cervical discectomy | 4 | Intraoperative dural tear | Surgical, Tisseel, Flowseal and subfascial drain | Left hand numbness, pain behind neck, hypersensitivity superior to the wound | None | 0 | 0 | ||
31 | Neuro | 72 | 30.72 | L3-4 decompression and discectomy | 10 | Intraoperative dural tear caused by removal of the ligamentum flavum | 6/0 Vicryl, surgical and Tisseel | CSF leak, sciatic pain and sensory changes over buttocks | None | 0 | 0 | |
32 | Neuro | 82 | 27.06 | L3/4 and L4/5 lumbar decompression and body fusion | 10 | Small dural tear with arachnoid intact, no CSF leak | Tissue dura | Ongoing back pain and bilateral lower limb symptoms | None | 0 | 0 | |
33 | Neuro | 46 | 36.57 | C5/6 and C6/7 ACDF and fusion | 2 | C5/6 small dural tear but no CSF leak | Surgical and Tisseel | Gait abnormalities and light touch sensation abnormalities | None | 0 | 0 | |
34 | Neuro | 50 | 34.90 | Laminectomy at L3-4 | 3 | Small dural tear with arachnoid intact, no CSF leak | Not Recorded | Back pain, frontal headaches and widespread sensory deficit to light touch | None | 0 | 0 | |
35 | Neuro | 50 | 25.14 | Microdiscectomy at L5-S1 | 3 | Small dural tear with arachnoid intact, no CSF leak | Tisseel | Discitis and infection | Yes | 1 | None | 1 |
36 | Neuro | 84 | 26.89 | L3/4 and L4/5 intersegmental and lateral recess decompression | 3 | Ligamentum adherent to dura, tore the dura when lifted | 6.0 Prolene, Tissue patch dura and Flowseal | Aching in anterior thighs and pelvis | None | 0 | 0 | |
37 | Neuro | 54 | 32.42 | L2/3 and L4/5 intersegmental decompression | 6 | Ligamentum was stuck to the dura dorsally under L4 | 6.0 Vicryl and duraseal | Pain and weakness in legs, made worse on walking | None | 0 | 0 | |
38 | Neuro | 45 | 24.22 | L4/5 decompression and discectomy | 4 | L5 dural tear | Vicryl 5/0, Prolene 7/0, TissuePatchDural and Tisseel | Headaches | None | 1 | L4/L5 wound exploration and repair of pseudomeningocele | 16 |
39 | Neuro | 39 | 26.04 | Right side L4/L5 microdiscectomy | 4 | Dural tear and pseudomeningocele noted 2 months post-operatively | 5/0 Prolene, Surgical, Tisseel and lumbar drain | Residual saddle anaesthesia and episodes of bladder incontinence | None | 1 | Repair of CSF leak and pseudomeningocele | 24 |
40 | Neuro | 42 | L5/S1 decompression | 11 | Dural tear in lateral aspect of S1 nerve root | Surgical and Tissue patch Dura | Infection and erythema with slight back pain and reduced light touch and pinprick sensation | Yes | 0 | 0 | ||
41 | Neuro | 30 | 31.8 | L5/S1 decompression | 4 | Small dural tear with subarachnoid intact | 6/0 Prolene, fat graft, Tisseel and lumbar drain | None | None | 0 | 0 | |
42 | Neuro | 20 | 45.7 | L4-5 decompression and microdiscectomy | Dural tear with bulging arachnoid | Lumbar drain | None | Yes | 0 | 0 | ||
43 | Neuro | 73 | 30.93 | C5-6 and C6-7 ACDF | 2 | Small dural tear with arachnoid intact, no CSF leak | Surgical and Floseal | Right arm radicular pain and slight sensory deficit | None | 0 | 0 | |
44 | Neuro | 65 | 18.34 | C6-7 corpectomy and iliac crest bone grafting and plating | 15 | Small dural tear with arachnoid intact, no CSF leak | Surgical, Floseal, blood patch and subfascial drain | Electric shock like symptoms in the right chest, dysphagia and weakness in the right C7 distribution | None | 0 | 0 | |
45 | Neuro | 69 | 31.67 | Anterior discectomy, fusion and fixation at C3-4 | 2 | Small dural tear with arachnoid intact, no CSF leak | Tisseel | Headaches, mild myelopathic gait and right L5 distributed sciatica | None | 2 | Nerve root block and L4/L5 laminectomy | 3 |
46 | Neuro | 53 | Two level ACDF | Small dural tear with arachnoid intact, no CSF leak | Fat graft, muscle graft, spongostan, Tisseel and Adherus | None | None | 0 | 0 | |||
47 | Neuro | 1 | Bilateral Excision of spinal neurofibroma | 5 | Small dural tear and CSF leak seen in axilla of C4 nerve root | Suture, tissue patch, muscle graft and duraseal | CSF leak | None | 1 | Aspiration of cervicothoracic pseudomeningocele, repair of dural tear and drain insertion | 94 | |
48 | Neuro | 66 | 34.62 | Bilateral Excision of spinal neurofibroma | 4 | Small dural tear in right lateral aspect of L4 | Prolene, muscle patch, bioglue and flowseal | Left hip and buttock pain with weakness of left hip flexion | Yes | 0 | 0 | |
49 | Neuro | 72 | 28.71 | Left L5 nerve root decompression and laminectomy | 3 | Small dural tear with arachnoid intact, no CSF leak | 6.0 Prolene, muscle graft and duraseal | Back pain | None | 0 | 0 | |
50 | Neuro | 35 | 30.07 | Insertion of right frontal VP shunt | 4 | Small dural tear causing haemorrhage | Bipolar diathermy | Severe hypotensive headaches and occipital pain with neck stiffness | None | 3 | Removal of shunt, lengthening and re-implantation of distal shunt catheter into peritoneum | 11 |
51 | Neuro | 78 | 31.23 | L4/L5 Discectomy and laminectomy | 4 | Small tear with adherent dura | Duragen patch, Duraseal and lumbar drain | None | None | 0 | 0 | |
52 | Ortho | 89 | 26.10 | L2/L3, L3/L4 and L4/L5 Decompression | 15 | Dural tear at L4/L5 | Duragen patch, Duraseal and lumbar drain | Right middle cerebral artery infarct | None | 0 | 0 | |
53 | Ortho | 77 | 31.75 | Midline primary surgery for lumbar disc degeneration | 12 | Small CSF Leak due to calcified ligamentum flavum | Vicryl 6.0 | Wound leak | None | 0 | 0 | |
54 | Ortho | 35 | 22.30 | L5/S1 decompression and discectomy | 8 | Small dural tear noted at the end of the procedure | Fat graft, nylon suture, duragen patch and duraseal | Left-sided foot drop | None | 0 | 0 | |
55 | Ortho | 48 | 41.62 | C3—C7 Laminectomy and C5/C6 Foraminotomy | 5 | Incidental small durotomy at C5/C6 | Prolene 6/0, Dural patch and Duroseal | Significant neck pain and worsening numbness in right thumb | None | 0 | 0 | |
56 | Ortho | 61 | 20.58 | Cervical decompression C2-C4 and instrumented fusion of C2-C5 | 38 | Post-op persisting wound leak and pseudomeningocele | Subfascial drain | Left ulnar neuropathy and grade 4 weakness and some muscle wasting | None | 0 | 0 | |
57 | Ortho | 34 | 33.14 | L4/L5 primary posterior laminectomy | 9 | Small dural tear noted during procedure | 8.0 Nylon, Everseal and lumbar drain | Saddle analgesia and S1 light touch sensory deficit | None | 0 | 0 | |
58 | Ortho | 41 | 42.90 | L4/L5 Decompression and discectomy | 3 | Small pin prick CSF leak | 6.0 Prolene and everseal | None | None | 0 | 0 | |
59 | Ortho | 69 | 34.57 | L2/L3 and L3/L4 Decompression | 7 | Ligamentum flavum partially adherent to dura | 6/0 Prolene, Duraseal and lumbar drain | Urinary retention | None | 0 | 0 | |
60 | Ortho | 76 | 27.55 | Instrumented fusion and decompression at L3-L5 | 5 | Inadvertent durotomy due to thickened calcified ligamentum adherent to dura | Duragen graft, duraseal and lumbar drain | Significant back and right-sided pain in the L5 distribution | None | 0 | 0 | |
61 | Ortho | 66 | 39.92 | L3-L5 posterior decompression and fusion and L4/5 PLIF | 9 | Incidental dural tear during the decompression at L4/L5 | Fat graft, Durogen and duroseal | None | None | 0 | 0 | |
62 | Ortho | 84 | 20.40 | L4/5 spinal decompression | Intraoperative dural tear | Duragen, Duraseal, Floseal, Patch and lumbar drain | Patient died | None | 0 | 0 | ||
63 | Ortho | 32 | L4/L5 discectomy | 3 | Incidental dural tear at L5 dorsal region | Prolene 5.0, durogen and duroseal | Back pain and occasional sharp pain | None | 0 | 0 | ||
64 | Ortho | 31 | 29.63 | Bilateral L4/L5 discectomy | 12 | Small central posterior durotomy | Fat graft, nylon suture, durapatch and duraseal | Weakness of the right leg distal to the knee associated with tingling and numbness | None | 0 | 0 | |
65 | Ortho | 82 | 32.76 | L3/L4 Decompression | 11 | Small inadvertent durotomy at L3 root | Prolene 6/0, Duragen and Evicell | pack pain, altered perianal and genital sensation with numbness | None | 0 | 0 | |
66 | Ortho | 60 | 36.54 | T10-L5 instrumented decompression and fusion | 43 | Dural tear intraoperatively at L3/L4 | Duragen patch and Everseal | Patient became paraplegic with major motor and sensory deficits | Yes | 0 | 0 | |
67 | Ortho | 59 | 32.18 | L2/3 and L3/4 decompression with dynamic stabilisation | 5 | Inadvertent dorsal linear tear of dura | 6–0 Prolene and Duraseal | Weak arms, hand tremor, numbness of left buttock and pelvic region | Yes | 0 | 0 | |
68 | Ortho | 55 | Posterior L2/3 decompression | 11 | Large complex dural tear | Duragen, durseal, flowseal and drain | Severe loss of sensation and power of the right leg | None | 0 | 0 | ||
69 | Ortho | 30 | 33.24 | Anterior and posterior correction and instrumentation of scoliosis | 13 | Small dural puncture in lumbar spine | Duragen, duraseal, Lumbar drain and local graft | Back pain | None | 0 | 0 | |
70 | Ortho | 16 | 23.75 | Posterior L5-S1 instrumented fusion | 8 | Small dural tear | Information not available | None | None | 1 | Revision left lateral ligament reconstruction | 5 |
71 | Ortho | 36 | 31.88 | L4/5 discectomy and decompression | 12 | Small Dural tear | 6–0 Prolene, duragen, duraseal | None | None | 0 | 0 | |
72 | Ortho | 52 | C5/6 reduction and instrumented fusion | 72 | Disc completely disrupted with dural tear at C5/C6 | Duroseal and subfascial drain | None | None | 0 | 0 | ||
73 | Ortho | 74 | 29.39 | Right anterior cervicotomy C6-C7 spinal cord decompression and fusion | Patient died | Medial dural tear | Spongostan | Patient died | None | 0 | 0 | |
74 | Ortho | 68 | 35.49 | L3 to S1 lumbar decompression | 7 | 5 mm longitudinal dural tear | 6–0 Prolene, Flowseal, Duraseal and lumbar drain | Back pain | None | 0 | 0 | |
75 | Ortho | 77 | 23.96 | L3/L4 and L4/L5 spinal decompression | 7 | Small linear dural tear at L5 | 6–0 Prolene, Flowseal and lumbar drain | None | None | 0 | 0 | |
76 | Ortho | 57 | 28.20 | Microdiscectomy of lumbar intervertebral disc | 6 | Dural tear at S1 root | 6–0 Prolene, Duragen, Duraseal and lumbar drain | Dysaesthesia in the left S1 distribution with marked cramps in left thigh | None | 0 | 0 | |
77 | Ortho | 57 | 31.79 | Spine decompression and pedicle subtraction osteotomy, T9-L4 | 45 | Dura adherent to the lamina resulting in dural tears at multiple levels | 6–0 Prolene, Duragen and Duraseal | Left foot numbness and loss of function at L5 in right foot | None | 0 | 0 | |
78 | Ortho | 76 | 18.49 | Posterior instrumented stabilisation T11-L3 and L1 laminectomy | 13 | Small dural tear | 6–0 Prolene Duragen, Duraseal and lumbar drain | Aching in mid thoracic spine | None | 0 | 0 | |
79 | Ortho | 65 | 23.66 | L1 and L2 laminectomy and L1 and L3 decompression | Patient died | Adherent dura resulting in small tear | 6–0 Prolene Duragen, Duraseal and lumbar drain | Patient died | None | 0 | 0 | |
80 | Ortho | 62 | 35.24 | Two Level spine decompression at the lumbar spine | 9 | Small dural tear | 6–0 Prolene, Duraseal and lumbar drain | Headache, photosensitivity and wound hypersensitivity | None | 0 | 0 | |
81 | Ortho | 73 | 27.21 | Two Level spine decompression at the lumbar spine | 5 | Small dural tear | 6–0 Prolene, Duraseal and lumbar drain | Leg aching | None | 0 | 0 | |
82 | Ortho | 74 | 38.67 | Three Level spine decompression at the lumbar spine | 23 | Small dural tear | Fat graft, duragen patch and durasell glue | Fluid collection, faecal and urinary retention and loss of anal tone and squeeze | None | 0 | 0 | |
83 | Ortho | 85 | 23.85 | Three Level spine decompression at the lumbar spine | Patient died | Intraoperative dural tear | Lumbar drain, glue and patch | Patient died | None | 0 | 0 | |
84 | Ortho | 29 | Posterior laminectomy decompression | 3 | Pinprick sized tear with CSF leak | Duraseal and dural patch | Pseudomenongocele, faecal and urinary incontinence | None | 1 | Dural tear repair | 8 | |
85 | Ortho | 74 | 40.88 | L3/4 decompression | 4 | Incidental small dural tear at L4 | Durogen and duroseal | None | None | 0 | 0 | |
86 | Ortho | 55 | 37.03 | L4-S1 posterior instrumented fusion and L5/S1 discectomy | 5 | Incidental dural tear at L5 root | Durogen, duroseal and lumbar drain | Right-sided back pain | None | 0 | 1 | |
87 | Ortho | 38 | 24.78 | Three Level spine decompression at the lumbar spine | 17 | Traumatic dural tear at L1 level posteriorly and anterior laterally | Durogene dressing, duroseal, 6–0 Prolene and lumbar drain | Incontinence | None | 0 | 2 | |
88 | Ortho | 25 | 38.31 | Open reduction of C6/7, ACDF | 6 | Traumatic dural tear | Duroseal and subfascial drain | None | None | 1 | Posterior cervical spine fusion | 7 |
89 | Ortho | 30 | L4/L5 discectomy | 3 | Small dural tear noted on left L4 nerve root | Dural patch, Duraseal and lumbar Drain | Good post-operative recovery | None | 0 | 0 | ||
90 | Ortho | 83 | 27.82 | L4/L5 Decompression | 16 | Dural tear noted distally | 6–0 Nylon, dural patch, duraseal and lumbar drain | 0/5 weakness of ankle dorsiflexion and toe extension in the right foot and reduced sensation | None | 0 | 0 | |
91 | Ortho | 75 | 24.82 | L4/L5 Decompression and TILF | 8 | Small dural tear noted | 6–0 Nylon sutures, dural patch, Duraseal and lumbar drain | Headaches | None | 0 | 0 | |
92 | Ortho | 67 | 22.46 | Posterior correction of scoliosis with instrumentation | 11 | 3 dural tears noticed | Primary repair, duragen patch and duraseal | Reduced L2 sensation | None | 1 | Elective posterior correction of post junctional kyphosis | 23 |
93 | Ortho | 69 | 36.09 | Posterior instrumented fusion L3-L5 and decompression laminectomy | 5 | Small dural tear at the axilla of L5 root | Duragen and Duraseal | None | None | 0 | 0 | |
94 | Ortho | 64 | 34.48 | T10-Pelvis scoliosis correction, fusion and decompression L4-S1 | 11 | Small dural tear at L5/S1 | 6–0 Prolene, Duraseal and lumbar Drain | Significant mid-lumbar pain | None | 1 | Revision degenerative scoliosis correction and TILF | 10 |
95 | Ortho | 36 | 31.90 | L4/L5 decompression discectomy | 4 | Small dural tear at L5 | Duraseal | Urinary leakage and ongoing right-sided back pain | None | 0 | 0 | |
96 | Ortho | 58 | 31.37 | Left L5 lateral recess decompression | 2 | Small dural tear at L5 | Duragen and patch | None | None | 0 | 1 | |
97 | Ortho | 58 | 35.32 | left L4/L5 discectomy/decompression | 5 | Dural tear at L4 | 6–0 Prolene, Dural patch and duraseal | Ongoing back ache and altered sensation over lateral left thigh | None | 0 | 2 | |
98 | Ortho | 60 | 28.16 | L4/L5 laminectomy, decompression and discectomy | 3 | Dural tear and CSF leak at L5 | Durseal and Duragen | Left-sided back pain | None | 0 | 3 | |
99 | Ortho | 66 | 34.09 | Discectomy | 2 | Small dural tear | Duraseal | Superficial wound infection | Yes | 0 | 4 | |
100 | Ortho | 30 | 38.41 | Lumbar decompression | 5 | Small dural tear | 6/0 nylon, Duragen, Duraseal and lumbar drain | Reoccurring CES symptoms | None | 3 | S1 nerve root block, bilateral S1 root decompression and re-do discectomy | 21 |
101 | Ortho | 69 | 37.96 | Lumbar decompression | 11 | Dural tear at superior edge of decompression | 6/0 Prolene, Duragen, duraseal and lumbar drain | Dysaesthesia in the perineal area and posterior aspect of both thighs and urinary urge sensation | None | 0 | 0 | |
102 | Ortho | 34 | 33.14 | Lumbar decompression | 8 | Small dural tear | 8.0 Nylon, Everseal and lumbar drain | Weaker erection than normal. Some sensory deficit | None | 0 | 0 | |
103 | Ortho | 64 | 31.46 | L3/L4 and L4/L5 Lumbar Decompression | 4 | Pinprick dural tear at L4/L5 | Duragen, Duraseal and lumbar drain | None | None | 0 | 0 | |
104 | Ortho | 49 | 35.11 | L5/S1 discectomy and decompression of the right S1 nerve root | 2 | Pseudomenngocele noticed post-operatively | Not recorded | Continued pain | None | 1 | Dural tear repair | 7 |
105 | Ortho | 66 | 25.06 | L3/L4 L4/L5 /S1 fusion | 7 | Small intraoperative dural tear at L3 root | Duragen and duraseal | Struggle with quadriceps post-operatively | None | 0 | 0 | |
106 | Ortho | 38 | 38.52 | L3/4 and L5/S1 decompression | 4 | Adherent dura at L3/4 | 6/0 Prolene and Duraseal | None | None | 0 | 0 |
Group number percentage | Number of patients (n) | Percentage of patients (%) |
---|---|---|
Primary closure alone | 1 | 0.94 |
Primary closure and artificial patch | 4 | 3.77 |
Primary closure and autologous patch | 3 | 2.83 |
Primary closure and sealant | 7 | 6.60 |
Primary closure and drain | 1 | 0.94 |
Primary closure, sealant and drain | 11 | 10.4 |
Primary closure, sealant and artificial patch | 10 | 9.43 |
Primary closure, sealant, artificial patch and drain | 10 | 9.43 |
Primary closure, sealant and autologous patch | 6 | 5.66 |
Primary closure, sealant and autologous patch and drain | 2 | 1.89 |
Primary closure, sealant, artificial patch and autologous patch | 2 | 1.89 |
Primary closure, artificial patch and drain | 2 | 1.89 |
Autologous patch and sealant | 1 | 0.94 |
Autologous patch and drain | 1 | 0.94 |
Sealant alone | 9 | 8.49 |
Sealant and drain | 3 | 2.83 |
Sealant and artificial patch | 9 | 8.49 |
Sealant, artificial patch and drain | 8 | 7.55 |
Sealant and autologous patch | 1 | 0.94 |
Sealant, autologous patch and drain | 2 | 1.89 |
Sealant, artificial patch and autologous patch | 2 | 1.89 |
Artificial patch alone | 2 | 1.89 |
Drain alone | 4 | 3.77 |
Unknown | 5 | 4.72 |
Total | 106 | 100 |
Statistical analysis
Delphi procedure
-
1. Length of hospital stay: ≤ 3 days.
-
2. Rate of readmissions or revision surgeries: < 2 readmissions or revision surgeries.
-
3. Length of additional admission(s): ≤ 7 days.
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4. Infection rate: No infection present.
-
5. Neurological symptoms: ≤ 3-point score.
Category | length of original stay | Infection | Readmissions | Length of additional stays | Symptoms |
---|---|---|---|---|---|
Group 1: Artificial patch | |||||
Patient | 5 | 0 | 0 | 0 | 4 |
Patient | 4 | 0 | 0 | 0 | 1 |
Patient | 5 | 0 | 0 | 0 | 0 |
Patient | 7 | 0 | 0 | 0 | 3 |
Number passed MCID | 4 | 4 | 4 | 4 | 3 |
Number not passed MCID | 0 | 0 | 0 | 0 | 1 |
Benefit rate (number passed/total number) | 100% | 100% | 100% | 100% | 75% |
Group 2: Autologous patch | |||||
Patient | 3 | 0 | 1 | 7 | 2 |
Patient | 5 | 0 | 0 | 0 | 5 |
Patient | 3 | 0 | 1 | 8 | 1 |
Number passed MCID | 2 | 3 | 1 | 2 | 2 |
Number not passed MCID | 1 | 0 | 2 | 1 | 1 |
Benefit rate (number passed/total number) | 67% | 100% | 33% | 67% | 67% |
Percentage improvement | 33 | 0 | 67 | 33 | 8 |
Incidence rate
Patient demographics
Type of repair method
Symptoms scoring 1 | Symptoms scoring 2 |
---|---|
Headache | Fistula formation |
Nausea | Pseudomeningocele |
Vomiting | Meningitis |
Stiffness or tightness across the neck or back | Abscesses |
Mild sensory disturbances | Arachnoiditis |
Temporary loss of power | Severe shooting pain |
Radicular pain | Sciatica |
Dizziness | Bladder, bowel or sexual problems |
Diplopia | |
Tinnitus | |
Fluid leak/collection | |
Vertigo |