Risk Factors for Dural Tears in Spinal Surgery: A Prospective Multicenter Registry Study of 1,853 Cases

Introduction: Dural tear (DT) is one of the most common complications in spinal surgery. High-quality cohort studies were needed to identify risk factors for DT, but accurate data are currently lacking. The purpose of this study was to clarify the predictors of 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 1,853 patients were enrolled. There were 81 cases with unintended DTs (4.4%; DT group) and 1,772 cases without DTs (non-DT group). Multivariate analysis revealed that old age, rheumatoid arthritis, and non-attending surgeon as the operator were significant risk factors for DTs. Conclusions: The incidence of DTs in spinal surgery was 4.4%, and identified risk factors were old age, rheumatoid arthritis, and non-attending surgeon as the operator.