Clinical Study
Accidental Durotomy in Minimally Invasive Transforaminal Lumbar Interbody Fusion: Frequency, Risk Factors, and Management
Table 1
Characterization and dural closure technique in patients with accidental durotomies.
| Patient number | Sex | Age (years) | BMI (kg/m2) | Level of durotomy | Contralateral decompression? | Site of durotomy | Previous surgery? | Adhesions scarring? | Durotomy during | Closure | Mobilization |
| 1 | Male | 76.4 | 29.8 | L4/5 | Yes | Ipsilateral | Yes | No | Cage implantation | Suture + TachoSil | 1st postop. day |
| 2 | Female |
73.0 |
27.0 | L3/4 | Yes | Ipsilateral | No | Yes | Cage implantation | TachoSil | 3rd postop. day | L4/5 | Yes | Contralateral | No | Yes | Decompression | TachoSil |
| 3 | Female |
79.6 |
27.8 | L3/4 | Yes | Ipsilateral | No | Yes | Decompression | TachoSil | 3rd postop. day | L4/5 | Yes | Contralateral | No | Yes | Decompression | TachoSil |
| 4 | Male | 68.6 | 38.2 | L2/3 | Yes | Ipsilateral | Yes | Yes | Decompression | TachoSil | 1st postop. day |
| 5 | Male | 71.6 | 33.2 | L3/4 | No | Ipsilateral | Yes | No | Cage implantation | TachoSil | 1st postop. day |
| 6 | Female | 65.2 | 32.3 | L4/5 | Yes | Contralateral | No | Yes | Decompression | TachoSil | 1st postop. day |
| 7 | Female | 71.4 | 34.0 | L4/5 | Yes | Ipsilateral | Yes | Yes | Decompression | TachoSil | 3rd postop. day |
| 8 | Female | 89.7 | 26.7 | L4/5 | Yes | Contralateral | No | Yes | Decompression | TachoSil | 1st postop. day |
| 9 | Male | 65.6 | 24.6 | L4/5 | Yes | Contralateral | No | No | Decompression | TachoSil | 1st postop. day |
| 10 | Female | 55.7 | 34.1 | L3/4 | Yes | Ipsilateral | No | No | Cage implantation | Suture + TachoSil | 1st postop. day |
| 11 | Male | 58.2 | 25.3 | L5/S1 | No | Ipsilateral | No | No | N/A | TachoSil | 1st postop. day |
| 12 | Female | 59.6 | 27.1 | L4/5 | Yes | N/A | No | No | Decompression | Suture + TachoSil | 1st postop. day |
| 13 | Female | 78.9 | 22.1 | L3/4 | Yes | Ipsilateral | Yes | No | Cage implantation | Gelfoam + fibrin glue | 2nd postop. day |
| 14 | Male | 66.2 | 28.4 | L4/5 | No | Ipsilateral | No | No | Decompression | TachoSil | 1st postop. day |
| 15 | Male | 64.4 | 34.3 | L4/5 | No | Ipsilateral | Yes | No | Decompression | TachoSil | 1st postop. day |
| 16 | Female | 55.0 | 33.8 | L4/5 | No | Ipsilateral | Yes | Yes | Decompression | TachoSil | 1st postop. day |
| 17 | Female | 74.2 | 44.3 | L3/4 | Yes | Ipsilateral | No | No | Decompression | Suture + TachoSil | 6th postop. day due to transitory psychotic syndrome |
| 18 | Male | 73.6 | 27.6 | L4/5 | No | Ipsilateral | Yes | Yes | Decompression | Suture + TachoSil | 1st postop. day |
| 19 | Male | 62.4 | 27.8 | L4/5 | Yes | Ipsilateral | No | Yes | Decompression | Suture + TachoSil | 1st postop. day |
| 20 | Female | 78.8 | 34.9 | L2/3 | No | Ipsilateral | Yes | No | Decompression | TachoSil | 2nd postop. day |
| 21 | Female | 71.7 | 27.3 | L3/4 | No | Ipsilateral | Yes | No | Decompression | Suture + TachoSil | 1st postop. day |
| 22 | Female | 75.3 | 31.0 | L4/5 | Yes | Ipsilateral | No | Yes | Decompression | Suture + TachoSil | 1st postop. day |
| 23 | Male | 66.0 | 24.8 | L4/5 | Yes | Ipsilateral | No | No | Decompression | TachoSil | 1st postop. day |
| 24 | Male | 62.5 | 30.7 | L4/5 | Yes | Ipsilateral | Yes | Yes | Cage implantation | TachoSil | 1st postop. day |
| 25 | Female | 75.2 | 27.9 | L4/5 | Yes | Contralateral | No | No | Decompression | TachoSil | 5th postop. day |
| 26 | Female | 70.1 | 40.4 | L5/S1 | Yes | Contralateral | No | No | Decompression | TachoSil | 2nd postop. day |
| 27 | Female | 65.5 | 24.2 | L4/5 | No | Ipsilateral | No | No | Decompression | TachoSil | 1st postop. day |
| 28 | Male | 78.5 | 24.4 | L4/5 | No | Ipsilateral | No | No | Decompression | Suture | N/A (died of multiple organ failure on postop. day 8) |
| 29 | Male | 79.4 | 26.1 | L4/5 | Yes | Ipsilateral | No | Yes | Decompression | Suture | 1st postop. day |
| 30 | Male | 44.4 | 29.2 | L4/5 | No | Ipsilateral | Yes | Yes | Decompression | None (due to intact arachnoidea) | 1st postop. day |
| Mean | | 69.2 | 30.0 | | | | | | | | 1.6 |
| Standard deviation | | 9.3 | 5.1 | | | | | | | | 1.3 |
| | 16 × female | | | 2 × L2/3 | 21 × yes | 24 × ipsilateral | 12 × yes | 15 × yes | 25 × decompression | 20 × TachoSil | |
| | 14 × male | | | 7 × L3/4 | 11 × no | 7 × contralateral | 20 × no | 17 × no | 6 × cage implantation | 8 × Suture + TachoSil | |
| | | | | 21 × L4/5 | | 1 × N/A | | | 1 × N/A | 2 × suture | |
| | | | | 2 × L5/S1 | | | | | | 1 × gelfoam + fibrin glue | |
| | | | | | | | | | | 1 × none | |
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BMI: body mass index. N/A: not available.
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