Dural lesions in lumbar disc herniation surgery: incidence, risk factors, and outcome |
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Authors: | Fredrik Strömqvist Bo Jönsson Björn Strömqvist |
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Institution: | (1) Department of Orthopedics, Lund University Hospital, 221 85 Lund, Sweden; |
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Abstract: | In lumbar disc herniation surgery, dural lesions seem to be the most common complication today. Studies on incidence of and
outcome after a dural lesion are mainly based on retrospective studies. In a prospective study within the framework of the
Swedish Spine Register, 4,173 patients operated on for lumbar disc herniation were evaluated using pre- and 1-year postoperative
protocols and complication registration. Mean patient age was 41 (18–81) years and 53% of the patients were male. 93% of the
operations were performed on the two lowermost lumbar levels. The incidence of dural lesions in the material was 2.7%. In
patients with previous disc surgery, the incidence was doubled, 5%, a significant increase (P = 0.02). Patients with dural lesions preoperatively had more back pain and inferior scores in general health and role emotional
domains of the SF-36. These factors, however, were because they had been operated on previously, not related to the dural
lesion as such. The relative improvement after surgery was similar whether a dural lesion had occurred or not. It is concluded
that a dural lesion is a technical complication which must be solved at the time of surgery but which does not bear any negative
implications on the long-term outcome for the patient. |
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Keywords: | Lumbar disc herniation Complication Surgery Outcome |
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