ABSTRACT
OBJECT The purpose of this prospective cohort study was to identify risk factors for incidental durotomies in lumbar spine surgery. The authors hypothesized that the incidence of durotomy would be higher in cases involving multiple operations. METHODS The authors prospectively evaluated 523 patients who underwent lumbar and thoracolumbar spine surgery. They compared data on patients in whom a dural tear occurred and those in whom a dural tear did not occur. Data from patients in whom a dural tear occurred were compared with data from patients who did not experience durotomy. The data included basic demographic information, intraoperative data, and clinical information from a medical record review. RESULTS One hundred thirty-one patients underwent discectomy and 392 patients underwent laminectomy. Among the 131 patients who underwent discectomy 6 patients had a dural tear. Among the 392 patients who underwent discectomy 49 patients had dural tear. Patients with incidental durotomy were older (mean 65 ± 13 vs 60 ± 14 years of age; p = 0.044, t-test), and had longer surgery (146 ± 59 vs 110 ± 54 minutes; p = 0.025, t-test), compared with the patients without dural tear. The incidence of dural tear was more common in patients with a history of previous spine surgery (p < 0.001). CONCLUSIONS In patients who underwent lumbar and thoracolumbar spine surgery for degenerative problems, previous surgery and older age were found to be predisposing factors for dural tear.
Subject(s)
Dura Mater/injuries , Lumbar Vertebrae/surgery , Aged , Diskectomy , Dura Mater/surgery , Female , Humans , Iatrogenic Disease , Laminectomy , Male , Middle Aged , Operative Time , Prospective Studies , Risk FactorsABSTRACT
AIM: To determine the most cited articles and most published authors in Spine Journal from 1990-2009. METHODS: Spine Journal, established in 1976, is affiliated with 12 spine societies and a leader in spine research articles. Citation analysis is a method to determine the impact of a journal and its articles on academia and clinical practice. Using the Institute for Scientific Information Web of Knowledge, we determined the most cited articles in Spine Journal between1990-2009. The characteristics and type of article were recorded. Next, we evaluated the most published authors during the same time period and calculated the number of citations for each author. The number of first authorships for each of these authors was also determined along with the number of citations for those articles. RESULTS: The top 20 cited articles range from 491 to 267 total citations. The top 20 published authors had between 41 and 135 articles. Seventeen of the top 20 articles were clinical studies. The range of citations per lead authorship ratio was 36 to 724 with one author having no lead authorships. Low back pain was the most common theme encountered in the top cited articles. The first-ranked article was not a spine-specific topic rather it was regarding general physical and mental health status survey update review. CONCLUSION: Spine Journal and its authors have a clear impact on the scientific community based on this review of the top articles and authors in the last 20 years.
