Multivariate analysis of risk factors for predicting incidental durotomy in lumbar surgery

Purpose: The purpose of the present study was to use a prospectively collected data to evaluate the rate of incidental durotomy (ID) during lumbar surgery and determine the associated risk factors by using univariate and multivariate analysis. Methods: We prospectively reviewed 2184 patients who underwent lumbar surgery from January 1, 2009 to December 31, 2011 at a single hospital. Patients with ID (n=97) were matched 1:1 to a control cohort without ID. The influences of several potential risk factors that might affect the occurrence of ID were assessed using univariate and multivariate analyses. Results: The overall incidence of ID was 4.62%. Univariate analysis demonstrated that older age, diabetes, lumbar central stenosis, posterior approach, revision surgery, prior lumber surgery and minimal invasive surgery are risk factors for ID during lumbar surgery. However, multivariate analysis identified older age, prior lumber surgery, revision surgery, and minimally invasive surgery as independent risk factors. Conclusion: Older age, prior lumber surgery, revision surgery, and minimal invasive surgery were independent risk factors for ID during lumbar surgery. These findings may guide clinicians making future surgical decisions regarding ID and aid in the patient counseling process to alleviate risks and complications.