Introduction: Unintentional durotomies occur in 2% to 5% of spine surgeries and in 20% of patients with spinal trauma. While neurosurgeons have historically managed intradural pathology, it is critical that all spine surgeons receive adequate training in the intraoperative and postoperative management of durotomies. Previous literature indicates notable interprogram heterogeneity regarding the quality of spinal surgery experience orthopaedic residents receive in their residency programs, however. To our knowledge, no study has previously studied orthopaedic resident education and experience regarding the management of unintentional durotomies. The purpose of this study was to evaluate resident education with management of unintentional durotomies in spine surgery.
Methods: This study was an anonymous eight-question survey sent to all 207 accredited orthopaedic residency programs investigating resident experience with the intraoperative and postoperative management of unintentional durotomies.
Results: Two hundred thirty-one residents responded to the survey, with 43.7% being senior residents (PGY4-5). Of the 231 respondents, 28.1% (65/231) reported feeling comfortable with the intraoperative management of durotomies. Regarding primary suture repair, 2.6% (6/231) stated that they have completed the procedure as lead surgeon, with 62.8% (145/231) having assisted an attending. 34.6% (80/231) of residents reported having never seen a suture repair. Regarding fibrin glue or muscle patch, 7.4% (17/231) reported performing the procedure as lead surgeon, with 48.1% (111/231) having partially completed or assisted (Figure 2). 44.6% (103/231) reported having never seen a patch repair. Of the 231, 52.8% (122/231) reported feeling comfortable with postoperative management of unintentional durotomies. 37.2% (86/231) stated that they do not feel comfortable managing lumbar drains. 59.7% (138/231) believed that they would benefit from additional experience during training.
Discussion: Unintentional durotomies occur frequently with notable morbidity. In this survey study of all accredited orthopaedic programs, residents reported limited experience with the management of unintentional durotomies with most reporting that they would benefit from additional experience during training.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.5435/JAAOS-D-24-01155 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Investigation of Orthopaedic Surgery Resident Education Regarding the Management of Unintentional Durotomies.
J Am Acad Orthop Surg
March 2025
From the Department of Orthopaedic Surgery, MedStar Georgetown University Hospital (Carroll, Johnson, and Ferguson), Georgetown University School of Medicine, Washington, DC (Lucas, Covell, and Backstrom).
Introduction: Unintentional durotomies occur in 2% to 5% of spine surgeries and in 20% of patients with spinal trauma. While neurosurgeons have historically managed intradural pathology, it is critical that all spine surgeons receive adequate training in the intraoperative and postoperative management of durotomies. Previous literature indicates notable interprogram heterogeneity regarding the quality of spinal surgery experience orthopaedic residents receive in their residency programs, however.
View Article and Find Full Text PDFAssociation Between Race and Short-Term Outcomes Across 3988 Consecutive Single-Level Spinal Fusions.
Neurosurgery
February 2024
Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Background And Objectives: Race has implications for access to medical care. However, the impact of race, after access to care has been attained, remains poorly understood. The objective of this study was to isolate the relationship between race and short-term outcomes across patients undergoing a single, common neurosurgical procedure.
View Article and Find Full Text PDFIntracranial Hypotension Syndrome: The Importance of Neurointensive Care.
Cureus
July 2023
Neurocritical Care Unit and Intensive Care, Hospital São João, Porto, PRT.
Surgical procedures involving the spine can result in various complications, including vascular, nerve root and dura mater injury, surgical wound infection, and hematoma formation. Unintentional durotomy is a frequent complication of these procedures (up to 17%). Two clinical cases are reported in which the occurrence of epileptiform activity in the form of generalized tonic-clonic seizures after instrumentation of the dorsal and lumbar spine raised suspicion of cerebrospinal fluid (CSF) fistula.
View Article and Find Full Text PDFSafety of Early Mobilization in Patients With Intraoperative Cerebrospinal Fluid Leak in Minimally Invasive Spine Surgery: A Case Series.
Oper Neurosurg (Hagerstown)
June 2021
Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, Canada.
Background: Cerebrospinal fluid (CSF) leak is a common complication in spine surgery. Repairing durotomy is more difficult in the setting of minimally invasive spine surgery (MISS). Efficacy of postoperative bed rest in case of dural tear in MISS is not clear.
View Article and Find Full Text PDFThe effect of vancomycin powder on human dural fibroblast culture and its implications for dural repair during spine surgery.
J Neurosurg Spine
November 2016
Department of Neurological Surgery, University of Pittsburgh School of Medicine, UPMC Health System, Pittsburgh, Pennsylvania; and.
OBJECTIVE Surgical site infections (SSIs) are a major source of morbidity after spinal surgery. Several recent studies have described the finding that applying vancomycin powder to the surgical bed may reduce the incidence of SSI. However, applying vancomycin in high concentrations has been shown in vitro to inhibit osteoblast proliferation and to induce cell death.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!