• World Neurosurg · Aug 2024

    Observational Study

    Economic implications of dural tears in lumbar microdiscectomies: a retrospective, observational study.

    • Tobias Prasse, Vincent J Heck, Jannik Leyendecker, Christoph P Hofstetter, Nikolaus Kernich, Peer Eysel, and Jan Bredow.
    • Department of Orthopedics and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Neurological Surgery, University of Washington, Seattle, Washington, USA. Electronic address: tobias.prasse@uk-koeln.de.
    • World Neurosurg. 2024 Aug 1; 188: e18e24e18-e24.

    ObjectiveDural tears (DTs) are a frequent complication after lumbar spine surgery. We sought to determine the incidence of DTs and the related impact on health care expenditures after lumbar discectomies.MethodsIn this retrospective cohort study, all patients with first-time single-level lumbar discectomies at our institution who underwent minimally invasive surgery from 2015 to 2019 were reviewed. Age, sex, weight, height, body mass index, costs, revenues, length of stay, American Society of Anesthesiologists score, Charlson Comorbidity Index, and operative time (OT) were assessed. Exclusion criteria were age <18 years, previous spine surgery, multiple or traumatic disc herniations, and malignant and infectious diseases.ResultsThe follow-up time was at least 12 months postoperatively. Of 358 patients identified with lumbar discectomies, 230 met the inclusion criteria. Incidence of DTs was 3.5%. Mean costs (P < 0.001), economic loss (P < 0.01), and OT (P < 0.0001) were found to be significantly higher in the DT group compared with the control group of patients without a DT. The revenues were not statistically different between the 2 groups (P > 0.05). Further analysis of the control group by profit and loss revealed significantly higher body mass index (P < 0.05), length of stay (P < 0.0001), and OT (P < 0.0001) in the loss group.ConclusionsDTs represent a significant socioeconomic burden in lumbar spine surgery and cause severe secondary complications. The impact of DTs on health care expenses is primarily based on significantly higher OT and a higher mean length of stay.Copyright © 2024. Published by Elsevier Inc.

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