Annals of African medicine · 2026
Incidence and Outcomes of Incidental Dural Tears Following Open Lumbar Spine Surgery: A Three-and-a-Half-Year Experience from Benin City, Nigeria.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Usiholo Ali Elijah, Akpede George Aighobahi, Idehen Hanson Osazuwa
Аннотация
BACKGROUND: Incidental durotomy is a recognized complication of lumbar spine surgery and may lead to cerebrospinal fluid (CSF) leakage, pseudomeningocele, meningitis, and prolonged hospitalization if not promptly recognized and adequately repaired. There is limited information on its incidence and management from sub-Saharan Africa. This study evaluated the incidence, risk factors, management, and early outcomes of incidental dural tears following open lumbar spine surgery in a Nigerian private neurosurgical practice.
METHODS: We conducted a retrospective review of 68 consecutive patients who underwent open lumbar spine surgery between July 2022 and December 2025. Patient demographics, operative characteristics, occurrence of incidental dural tears, methods of repair, and postoperative outcomes were analyzed. Comparisons between patients with and without dural tears were performed using the Mann-Whitney U-test and Fisher's exact test, with statistical significance set at P < 0.05.
RESULTS: Incidental dural tears occurred in 9 of 68 (13.2%) patients. Thirty-five (51.5%) patients underwent single-level decompression, while 33 (48.5%) underwent multilevel decompression. Dural tears occurred in 4 of 35 (11.4%) patients undergoing single-level decompression and in 5 of 33 (15.2%) patients undergoing multilevel decompression, with no significant association between multilevel surgery and incidental durotomy (P = 0.65). Both patients with previous lumbar surgery sustained incidental dural tears, and previous surgery was significantly associated with durotomy (P = 0.016). All dural tears were recognized intraoperatively and repaired immediately using primary suture closure with selective adjunctive use of autologous fascial grafts and cyanoacrylate sealant. No patient developed persistent CSF leakage or meningitis, and one patient developed a pseudomeningocele that resolved with conservative management.
CONCLUSION: Incidental durotomy occurred in 13.2% of patients undergoing open lumbar spine surgery in this series. Prompt intraoperative recognition and layered repair resulted in favorable early outcomes. Although previous lumbar surgery was significantly associated with incidental durotomy, this finding should be interpreted cautiously because of the small number of revision procedures. Larger prospective multicenter studies are required to better define risk factors and optimize management in similar resource-limited settings.
METHODS: We conducted a retrospective review of 68 consecutive patients who underwent open lumbar spine surgery between July 2022 and December 2025. Patient demographics, operative characteristics, occurrence of incidental dural tears, methods of repair, and postoperative outcomes were analyzed. Comparisons between patients with and without dural tears were performed using the Mann-Whitney U-test and Fisher's exact test, with statistical significance set at P < 0.05.
RESULTS: Incidental dural tears occurred in 9 of 68 (13.2%) patients. Thirty-five (51.5%) patients underwent single-level decompression, while 33 (48.5%) underwent multilevel decompression. Dural tears occurred in 4 of 35 (11.4%) patients undergoing single-level decompression and in 5 of 33 (15.2%) patients undergoing multilevel decompression, with no significant association between multilevel surgery and incidental durotomy (P = 0.65). Both patients with previous lumbar surgery sustained incidental dural tears, and previous surgery was significantly associated with durotomy (P = 0.016). All dural tears were recognized intraoperatively and repaired immediately using primary suture closure with selective adjunctive use of autologous fascial grafts and cyanoacrylate sealant. No patient developed persistent CSF leakage or meningitis, and one patient developed a pseudomeningocele that resolved with conservative management.
CONCLUSION: Incidental durotomy occurred in 13.2% of patients undergoing open lumbar spine surgery in this series. Prompt intraoperative recognition and layered repair resulted in favorable early outcomes. Although previous lumbar surgery was significantly associated with incidental durotomy, this finding should be interpreted cautiously because of the small number of revision procedures. Larger prospective multicenter studies are required to better define risk factors and optimize management in similar resource-limited settings.