• World Neurosurg · Nov 2020

    Management of Incidental Durotomy: Results from a Nationwide Survey Conducted by the French Society of Spine Surgery.

    • Henri d'Astorg, Marc Szadkowski, Thais Dutra Vieira, Cyril Dauzac, Nicolas Lonjon, Renaud Bougeard, Stephane Litrico, Martin Dupuy, and members of the French Society of Spine Surgery (Societe Francaise de Chirurgie du Rachis).
    • Centre Orthopédique Santy, Lyon, France; Hopital Privé Jean, Mermoz, Ramsay-Générale de Santé, Lyon, France.
    • World Neurosurg. 2020 Nov 1; 143: e188-e192.

    ObjectiveTo obtain real-life data on the most common practices used for management of incidental durotomy (ID) in France.MethodsData were collected from spinal surgeons using a practice-based online questionnaire. The survey comprised 31 questions on the current management of ID in France. The primary outcome was the identification of areas of consensus and uncertainty on ID follow-up.ResultsA total of 217 surgeons (mainly orthopaedic surgeons and neurosurgeons) completed the questionnaire and were included in the analysis. There was a consensus on ID repair with 94.5% of the surgeons considering that an ID should always be repaired, if repairable, and 97.2% performing a repair if an ID occurred. The most popular techniques were simple suture or locked continuous suture (48.3% vs. 57.8% of surgeons). Nonrepairable IDs were more likely to be treated with surgical sealants than with an endogenous graft (84.9% vs. 75.5%). Almost two thirds of surgeons (71.6%) who adapted their standard postoperative protocol after an ID recommended bed rest in the supine position. Among these, 48.8% recommended 24 hours of bed rest, while 53.5% recommended 48 hours of bed rest. The surgeons considered that the main risk factors for ID were revision surgery (98.6%), patient's age (46.8%), surgeon's exhaustion (46.3%), and patient's weight (21.3%).ConclusionsThis nationwide survey reflects the lack of a standardized management protocol for ID. Practices among surgeons remain very heterogeneous. Further consensus studies are required to develop a standard management protocol for ID.Copyright © 2020 Elsevier Inc. All rights reserved.

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