Incidental durotomy during tubular microdiscectomy does not preclude same-day discharge.

Autor: Liu E; Division of Neurosurgery, Department of Surgery, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada., Saeed S; Division of Neurosurgery, Department of Surgery, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada., Coote NR; Division of Neurosurgery, Department of Surgery, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada., Su J; Division of Neurosurgery, Department of Surgery, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada., Toyota PR; Division of Neurosurgery, Department of Surgery, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada.; Department of Neurosurgery, Stanford University, Palo Alto, CA, USA., Newton BD; Division of Neurosurgery, Department of Surgery, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada., Persad AR; Department of Neurosurgery, Stanford University, Palo Alto, CA, USA., Fourney DR; Division of Neurosurgery, Department of Surgery, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada. daryl.fourney@usask.ca.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2024 Nov; Vol. 33 (11), pp. 4392-4396. Date of Electronic Publication: 2024 Sep 11.
DOI: 10.1007/s00586-024-08470-9
Abstrakt: Purpose: One of the major advantages of a minimally invasive microdiscectomy is that when CSF leak occurs, there is minimal anatomic dead space for ongoing leakage following removal of the tubular retractor. However, there are no published reports that address the safety and long-term outcomes of same-day discharge for CSF leak after tubular microdiscectomy.
Methods: This is a retrospective compartive study of 30 patients with incidental durotomy during minimally invasive tubular microdiscectomy occurring between January 1, 2009 to August 31, 2023 at our institution.
Results: There were 16 patients (53%) admitted to hospital and 14 (47%) patients discharged home the same day following CSF leak. There were no differences in patient demographics between the two groups at baseline. Twenty-nine out of 30 (97%) of the patients had onlay duraplasty, and one (3%) patient was repaired using sutures through the tubular retractor. None were converted to an open approach. The hospitalized group was kept on bed rest overnight or for 24 h. The discharge group was kept on best rest for 2 h or mobilized immediately after surgery. No patients in either group required readmission or revision surgery for CSF leak. The average length of admission for the hospitalized group was 2.4 ± 4.0 days.
Conclusion: Patients with CSF leak during minimally invasive tubular microdiscectomy can be safely discharged home the same day.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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