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A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.

TitleA Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.
Publication TypeJournal Article
Year of Publication2017
AuthorsO'Neill KR, Fehlings MG, Mroz TE, Smith ZA, Hsu WK, Kanter AS, Steinmetz MP, Arnold PM, Mummaneni PV, Chou D, Nassr A, Qureshi SA, Cho SK, Baird EO, Smith JS, Shaffrey C, Tannoury CA, Tannoury T, Gokaslan ZL, Gum JL, Hart RA, Isaacs RE, Sasso RC, Bumpass DB, Bydon M, Corriveau M, De Giacomo AF, Derakhshan A, Jobse BC, Lubelski D, Lee S, Massicotte EM, Pace JR, Smith GA, Than KD, K Riew D
JournalGlobal Spine J
Volume7
Issue1 Suppl
Pagination58S-63S
Date Published2017 Apr
ISSN2192-5682
Abstract

STUDY DESIGN: Retrospective multicenter case series study.

OBJECTIVE: Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears.

METHODS: Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization.

RESULTS: There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears.

CONCLUSIONS: In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

DOI10.1177/2192568216688186
Alternate JournalGlobal Spine J
PubMed ID28451493
PubMed Central IDPMC5400193