{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:24:30Z","timestamp":1794324270345,"version":"4.9.0"},"reference-count":84,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Unintended durotomy is one of the most common complications in spine surgery that may lead to serious complications if not recognized or treated properly. There are few reports on the management of durotomies incurred during minimally invasive spine surgery (MISS). The authors describe their experience in a series of consecutive MISS patients with unintended durotomies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients who underwent MISS by the senior author between August 2006 and February 2011 were retrospectively reviewed, and cases with unintended durotomies were identified. A case-control study was carried out comparing patient demographics and perioperative data between patients with and without durotomy. Surgical technique, including a proposed algorithm for management of durotomies, is described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Unintended durotomy occurred in 53 (9.4%) of 563 patients. The mean age at surgery was 60.7 years (range 30\u201385 years). Previous surgery at the same level was performed in 5 patients (9.4%). Two patients underwent posterior cervical surgery, and 51 patients underwent posterior lumbar surgery. Decompression alone was performed in 32 patients (60.4%), and fusion was performed in 21 patients (39.6%). The mean operative time was 105 minutes in the decompression group and 310 minutes in the fusion group (p &lt; 0.001). Estimated blood loss was 60 ml in the decompression group and 381 ml in the fusion group (p &lt; 0.001). The hospital length of stay was 52 hours in the decompression group and 106 hours in the fusion group (p &lt; 0.001). The mean follow-up was 310 days, and there were no cases of cutaneous CSF fistula, pseudomeningocele, or other complications referable to durotomy in either group. Risk factors identified for durotomy included previous operation at the same level (p = 0.019) and operation in the lumbar spine region (p = 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the authors' consecutive series of patients undergoing MISS, an unintended durotomy was associated with fewer complications than previously reported for open spinal surgery. The authors propose a simple management algorithm that includes early mobilization and results in excellent clinical outcomes with no incidence of postoperative cutaneous CSF fistula or other complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2011.7.focus11122","type":"journal-article","created":{"date-parts":[[2011,9,30]],"date-time":"2011-09-30T13:13:31Z","timestamp":1317388411000},"page":"E15","source":"Crossref","is-referenced-by-count":82,"title":["Management of incidental durotomy in minimally invasive spine surgery"],"prefix":"10.3171","volume":"31","author":[{"given":"Dmitry","family":"Ruban","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"O'Toole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0310015","series-title":"J Spinal Disord","first-page":"205","article-title":"Clinical factors predicting outcome after surgery for herniated lumbar disc: an epidemiological multivariate analysis","volume":"3","author":"Barrios","year":"1990"},{"issue":"3 Suppl Operative","key":"b2-0310015","series-title":"Neurosurgery","first-page":"E124","article-title":"Aneurysm clips for durotomy repair: technical note","volume":"66","author":"Beier","year":"2010"},{"key":"b3-0310015","series-title":"Clin Orthop Relat Res","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1097\/00003086-200108000-00033","article-title":"Evaluation and treatment of dural tears in lumbar spine surgery: a review","volume":"389","author":"Bosacco","year":"2001"},{"key":"b4-0310015","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2663","DOI":"10.1097\/00007632-200010150-00019","article-title":"Incidental durotomy in spine surgery","volume":"25","author":"Cammisa","year":"2000"},{"key":"b5-0310015","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1227\/00006123-198108000-00016","article-title":"Cerebellar hemorrhage complicating cervical laminectomy","volume":"9","author":"Chadduck","year":"1981"},{"issue":"5 Suppl 2","key":"b6-0310015","series-title":"Neurosurgery","first-page":"356","article-title":"Primary dural repair during minimally invasive microdiscectomy using standard operating room instruments","volume":"64","author":"Chou","year":"2009"},{"issue":"6","key":"b7-0310015","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Spinal pseudomeningoceles and cerebrospinal fluid fistulas","volume":"15","author":"Couture","year":"2003"},{"key":"b8-0310015","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1227\/NEU.0b013e3182134171","article-title":"SPORT: does incidental durotomy affect long-term outcomes in cases of spinal stenosis?","volume":"69","author":"Desai","year":"2011"},{"key":"b9-0310015","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"647","DOI":"10.3171\/2011.1.SPINE10426","article-title":"Outcomes after incidental durotomy during firsttime lumbar discectomy. 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