{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T09:43:06Z","timestamp":1780566186253,"version":"3.54.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100013015","name":"Cedars-Sinai Medical Center","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013015","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To characterize the frequency of incidental dural tears in pediatric spine surgery, their treatment, complications, and results of long-term follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective review of all pediatric patients who underwent a posterior spinal fusion (PSF) between 2004\u20132019 at a tertiary children\u2019s hospital was conducted. Electronic medical records were reviewed for patient demographics, intra-operative data, presence of an incidental dural tear, repair method, and patient outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>3043 PSFs were reviewed, with 99 dural tears identified in 94 patients (3.3% overall incidence). Mean follow-up was 35.7\u00a0months (range 0.1\u2013142.5). When the cause of the dural tear was specified, 69% occurred during exposure, 5% during pedicle screw placement, 4% during osteotomy, 2% during removal of implants, and 2% during intra-thecal injection of morphine. The rate of dural tears during primary PSF was significantly lower than during revision PSF procedures (2.6% vs. 6.2%, p\u2009&lt;\u20090.05). 86.9% of dural tears were repaired and\/or sealed intraoperatively, while 13.1% had spontaneous resolution. Postoperative headaches developed in 13.1% of patients and resolved at a mean of 7.6\u00a0days. There was no difference in the incidence of headaches in patients that were ordered bedrest vs. no bedrest (p\u2009&gt;\u20090.99). Postoperative infections occurred in 9.5% of patients and 24.1% patients were identified to have undergone a revision surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Incidence of intra-operative dural tears in pediatric spine surgery is 3.3%. Although complications associated with the dural tear occur, most resolve over time and there were no long-term sequelae in patients with 2\u00a0years of follow up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of evidence<\/jats:title>\n                <jats:p>Level IV.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s43390-024-00873-4","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T14:02:18Z","timestamp":1716472938000},"page":"1277-1282","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Incidental dural tears during pediatric posterior spinal fusions"],"prefix":"10.1007","volume":"12","author":[{"given":"Paal K.","family":"Nilssen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Compton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Stephan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay M.","family":"Andras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason K.","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Skaggs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7088-5906","authenticated-orcid":false,"given":"Kenneth D.","family":"Illingworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"issue":"11","key":"873_CR1","doi-asserted-by":"publisher","first-page":"E660","DOI":"10.1097\/BRS.0000000000001924","volume":"42","author":"R De la Garza Ramos","year":"2017","unstructured":"De la Garza Ramos R et al (2017) Primary versus revision spinal fusion in children: an analysis of 74,525 cases from the nationwide inpatient sample. Spine 42(11):E660\u2013E665","journal-title":"Spine"},{"issue":"5","key":"873_CR2","doi-asserted-by":"publisher","first-page":"591","DOI":"10.3171\/2018.5.PEDS17690","volume":"22","author":"JL West","year":"2018","unstructured":"West JL et al (2018) Incidental durotomy in the pediatric spine population. J Neurosurg Pediatr 22(5):591\u2013594","journal-title":"J Neurosurg Pediatr"},{"issue":"1","key":"873_CR3","doi-asserted-by":"publisher","first-page":"37","DOI":"10.3171\/2010.10.PEDS10212","volume":"7","author":"KM Fu","year":"2011","unstructured":"Fu KM et al (2011) Morbidity and mortality associated with spinal surgery in children: a review of the scoliosis research society morbidity and mortality database. 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Nilssen, Edward Compton, Stephen Stephan, Kenneth D. Illingworth & Jason K. Chu: None. Lindsay M. Andras: Biomet: Paid consultant; Paid presenter or speaker; Eli Lilly: Stock or stock Options; Journal of Pediatric Orthopedics: Editorial or governing board; Medtronic: Paid consultant; Paid presenter or speaker; Nuvasive: Paid consultant; Paid presenter or speaker; Orthobullets: Publishing royalties, financial or material support; Pediatric Orthopaedic Society of North America: Board or committee member; Scoliosis Research Society: Board or committee member; Zimmer: Paid consultant. David L. Skaggs: CHLA Foundation: Board or committee member; Grand Rounds: Paid consultant; Green Sun Medical: Stock or stock Options; Growing Spine Foundation: Board or committee member; Growing Spine Study Group: Board or committee member; Journal of Children's Orthopaedics: Editorial or governing board; Medtronic: Other financial or material support; Nuvasive (Co-PI, Paid to Growing Spine Foundation): Research support; Orthobullets: Editorial or governing board; Paid consultant; Stock or stock Options; Orthopedics Today: Editorial or governing board; Spine Deformity: Editorial or governing board; Wolters Kluwer Health: Publishing royalties, financial or material support; ZimmerBiomet: IP royalties; Other financial or material support; Paid consultant; Paid presenter or speaker; Zipline Medical, Inc.: Stock or stock Options.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study has been carried out with approval from the Institutional Review Board at Children\u2019s Hospital Los Angeles.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"IRB"}}]}}