Risk Factors for Dural Tears in Spinal Surgery: A Prospective Multicenter Registry Study of 1,698 Cases

Purpose: To clarify the predictors of dural tear (DT) through a prospective cohort study with a low dropout rate. Methods: In this prospective multicenter cohort study in Japan, a registry was established to collect information about patients undergoing spinal surgery between July 1, 2020 and June 30, 2021 at 10 hospitals. Clinical features, laboratory data, and operative factors were collected from the database. Risk factors were analyzed by comparing DT and non-DT groups. Results: A total of 1,698 patients were enrolled. There were 74 cases with unintended DTs (4.4%; DT group) and 1624 cases without DTs (non-DT group). Multivariate analysis revealed that age, rheumatoid arthritis, non-attending surgeon as the operator, and creatinine kinase were significant risk factors for DTs. Conclusions: The incidence of DTs in spinal surgery was 4.4%, and identified risk factors were age, rheumatoid arthritis, non-attending surgeon as the operator, and creatinine kinase.