• Patrick Guerin, Abdelkrim Benchikh El Fegoun, Ibrahim Obeid, Olivier Gille, Luc Lelong, Stéphane Luc, Anouar Bourghli, Jean Christophe Cursolle, Vincent Pointillart, and Jean-Marc Vital.
• Department of Orthopaedic Surgery, University Hospital of Bordeaux, Spinal Unit, Place Amélie Raba Léon, Bordeaux, France. pguerin_patrick@yahoo.fr
• Injury. 2012 Apr 1;43(4):397-401.

Study DesignRetrospective review of a series of patients who underwent spinal surgery at a single spine unit during a 1 year period.ObjectivesTo assess the incidence, treatment, clinical consequence, complications of incidental durotomy during spine surgery and results of 37 months clinical follow-up.Summary Of Background DataIncidental durotomy is an underestimated and relatively adverse event during spinal surgery. Several consequences of inadequately treated dural tears have been reported.MethodsA retrospective review was conducted on 1326 consecutive patients who underwent spinal surgery performed in one French spine unit from January 2005 to December 2005. We excluded from this study patients treated for emergency spine cases.ResultsFifty-one dural tears were identified (3.84%). Incidental durotomies were associated with anterior cervical approach in 1 case, with posterior cervical approach in 1 case, with anterior retroperitoneal approach in 1 case and with posterior thoracolumbar approach in 48 cases. In addition, any clinically significant durotomy unrecognised during surgical procedure were included. Thirteen patients presented postoperative complications including 7 cerebrospinal fluid leaks, 2 wound infections, 2 postoperative haematomas, and 2 pseudomeningoceles. Nine of these 13 patients required a revision procedure. A mean follow-up of 37 months showed good long-term clinical results.ConclusionsIncidental durotomy is a common complication of spine surgery. All incidental durotomies must be repaired primarily. Dural tears that were immediately recognised and treated accordingly did not lead to any significant sequelae at a mean follow-up of 37 months. However, long-term follow-up studies will be needed to confirm this finding. The risks associated with dural tears and cerebrospinal fluid leaks are serious and should be discussed with any patients undergoing spine surgery.Copyright © 2010 Elsevier Ltd. All rights reserved.

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