The researchers examined the Nationwide Inpatient Sample database from 2008 to 2011 for patients who underwent cervical and lumbar decompression and/or fusion. Incidental durotomy rate was calculated and costs analyzed for a full report. Here are the findings:
1. Incidental durotomy in cervical spine surgery was 0.4 percent and in lumbar spine surgery was 2.9 percent. A study conducted at the University of Miami Miller School of Medicine reported incidental durotomy at 1.3 percent for cervical cases and 5.1 percent for thoracolumbar cases.
2. Patients with incidental durotomy had a longer hospitalization and a greater risk of perioperative complications such as hematoma and neurological injury. In the University of Miami study, incidental durotomy was lower for cases involving instrumentation and higher for training physicians. Residents accounted for 49 percent of the incidental durotomies while fellows accounted for 26 percent and attendings for 25 percent. Incidence rate was also higher during revision procedures.
3. Cervical durotomy and its postoperative sequela added around $7,638 to the total hospital costs.
4. Lumbar durotomy contributed an additional $2,412 to the total hospital costs. However, the approach-specific procedural groups demonstrated similar discrepancies in the average total hospital costs for patients who experienced incidental durotomy.
5. The study conducted at the University of Miami Miller School of Medicine examined incidental durotomy rate as well, analyzing more than 3,000 total cases. The incidence of incidental durotomy was 3.3 percent during minimally invasive procedures, similar to the overall elective procedure rate.
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