⚠ Official Notice: www.ijisrt.com is the official website of the International Journal of Innovative Science and Research Technology (IJISRT) Journal for research paper submission and publication. Please beware of fake or duplicate websites using the IJISRT name.



Predictive Indicators of Traumatic Dural Tear in Dorsal and Lumbar Spine Fractures and an Integrated Clinical–Imaging Risk Score: A Retrospective Study


Authors : Dr. Deepak Kumar Raidas; Dr. Ram Parsad Meena; Dr. Umesh Kumar Meena; Dr. Kishan Gopal Nama

Volume/Issue : Volume 11 - 2026, Issue 8 - August


Google Scholar : https://tinyurl.com/4hdf7rkr

DOI : https://doi.org/10.38124/ijisrt/26aug1012

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Background: Traumatic dural tears (TDTs) are clinically significant complications associated with thoracolumbar spine fractures and may result in cerebrospinal fluid leakage, pseudo meningocele formation, infection, and delayed recovery. Early recognition of patients at risk for TDT can assist in surgical planning, reduce complications, and improve postoperative outcomes.  Objective: To identify clinical and radiological predictors of traumatic dural tears in patients with thoracolumbar spine fractures and to develop an integrated clinical–imaging risk score for preoperative prediction.  Methods: A retrospective cohort study was conducted at a tertiary care centre between August 2022 and May 2025. Patients who underwent surgical management for thoracolumbar fractures and had complete preoperative imaging and intraoperative documentation were included. Demographic variables, mechanism of injury, AO Spine classification, neurological status according to the ASIA scale, and radiological parameters were analysed. Radiological variables included canal compromise, laminar fracture, pedicle fracture, retro pulsed fragments, CSF signal discontinuity, loss of epidural fat plane, and dural spiking sign. Intraoperative confirmation of dural tear served as the reference standard.

Keywords : Traumatic Dural Tear; Thoracolumbar Fracture; Laminar Fracture; Paraplegia; MRI Predictors; Risk Score.

References :

  1. Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine (Phila Pa 1976). 1983;8(8):817–31.
  2. Vaccaro AR, Lehman RA Jr, Hurlbert RJ, et al. A new classification of thoracolumbar injuries. Spine (Phila Pa 1976). 2005;30(20):2325–33.
  3. Wang JC, Bohlman HH, Riew KD. Dural tears secondary to operations on the lumbar spine. J Bone Joint Surg Am. 1998;80(12):1728–32.
  4. Fehlings MG, Tetreault LA, Wilson JR, et al. A clinical practice guideline for the management of acute spinal cord injury. Global Spine J. 2017;7(3 Suppl):84S–94S.
  5. Fehlings MG, Vaccaro A, Wilson JR, et al. Early versus delayed decompression for traumatic spinal cord injury. PLoS One. 2012;7(2):e32037.
  6. Kim KT, Lee SH, Suk KS, et al. Dural tears in spinal surgery: risk factors and management. Spine (Phila Pa 1976). 2008;33(20):E723–9.
  7. Moon MS, Choi WT, Moon YW, et al. Dural tears in spinal burst fractures. Spine (Phila Pa 1976). 1996;21(17):2016–22.
  8. Lee HM, Kim HS, Kim DJ, et al. Reliability of MRI for detecting posterior ligament complex injury. Spine (Phila Pa 1976). 2000;25(16):2079–84.
  9. Aono H, Tobimatsu H, Ariga K, et al. MRI predictors of traumatic dural tears in thoracolumbar burst fractures. Spine J. 2018;18(10):1755–62.
  10. Kanna RM, Shetty AP, Rajasekaran S. Imaging predictors of dural tears in thoracolumbar trauma. Eur Spine J. 2020;29(8):1986–94.
  11. Wang MY, Hoh DJ, Leary SP, et al. Management of incidental durotomy in spine surgery. Neurosurg Focus. 2008;25(2):E15.
  12. Harrop JS, Sharan A, Przybylski GJ. Epidemiology of spinal cord injury. Neurosurg Focus. 2000;8(6):e4.
  13. Chen WJ, Niu CC, Chen LH, et al. Traumatic dural tears in thoracolumbar burst fractures. Spine (Phila Pa 1976). 2001;26(18):E387–92.
  14. Holdsworth F. Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg Am. 1970;52(8):1534–51.
  15. Wood KB, Li W, Lebl DR, et al. Management of thoracolumbar spine fractures. Spine J. 2014;14(1):145–64.
  16. Qian BP, Qiu Y, Wang B, et al. Risk factors for dural tears in thoracolumbar burst fractures. Orthop Surg. 2012;4(2):85–9.
  17. Aono H, Ohwada T, Kaneko N, et al. Incidence of dural tears associated with laminar fractures. Spine (Phila Pa 1976). 2007;32(1):E38–45.
  18. Kanna RM, Rajasekaran S. Role of MRI in predicting dural tears in spinal trauma. J Orthop Trauma. 2021;35(Suppl 2):S12–8.
  19. Li Y, Shen Y, Zhang Y, et al. MRI features predicting traumatic dural tears in thoracolumbar fractures. Clin Radiol. 2022;77(6):e418–25.
  20. Park HY, Kim HJ, Kim HS, et al. Preoperative MRI predictors of dural injury in thoracolumbar burst fractures. Asian Spine J. 2023;17(2):278–86.
  21. Kulkarni AG, Shah SP, Kulkarni MG, et al. Posterior decompression and stabilization for thoracolumbar fractures. Indian J Orthop. 2012;46(3):272–8.
  22. Vaccaro AR, Oner C, Kepler CK, et al. AOSpine thoracolumbar spine injury classification system. Spine (Phila Pa 1976). 2013;38(23):2028–37.
  23. Kirshblum SC, Burns SP, Biering-Sorensen F, et al. International standards for neurological classification of spinal cord injury. J Spinal Cord Med. 2011;34(6):535–46.
  24. Hashimoto T, Kaneda K, Abumi K. Relationship between spinal canal compromise and neurological deficit. Spine (Phila Pa 1976). 1988;13(11):1268–72.
  25. Zhang J, Wang L, Liu Z, et al. Advanced MRI signs of dural disruption in thoracolumbar trauma. Eur Radiol. 2024;34(1):512–21.

Background: Traumatic dural tears (TDTs) are clinically significant complications associated with thoracolumbar spine fractures and may result in cerebrospinal fluid leakage, pseudo meningocele formation, infection, and delayed recovery. Early recognition of patients at risk for TDT can assist in surgical planning, reduce complications, and improve postoperative outcomes.  Objective: To identify clinical and radiological predictors of traumatic dural tears in patients with thoracolumbar spine fractures and to develop an integrated clinical–imaging risk score for preoperative prediction.  Methods: A retrospective cohort study was conducted at a tertiary care centre between August 2022 and May 2025. Patients who underwent surgical management for thoracolumbar fractures and had complete preoperative imaging and intraoperative documentation were included. Demographic variables, mechanism of injury, AO Spine classification, neurological status according to the ASIA scale, and radiological parameters were analysed. Radiological variables included canal compromise, laminar fracture, pedicle fracture, retro pulsed fragments, CSF signal discontinuity, loss of epidural fat plane, and dural spiking sign. Intraoperative confirmation of dural tear served as the reference standard.

Keywords : Traumatic Dural Tear; Thoracolumbar Fracture; Laminar Fracture; Paraplegia; MRI Predictors; Risk Score.

Paper Submission Last Date
30 - September - 2026

SUBMIT YOUR PAPER CALL FOR PAPERS
Video Explanation for Published paper

Never miss an update from Papermashup

Get notified about the latest tutorials and downloads.

Subscribe by Email

Get alerts directly into your inbox after each post and stay updated.
Subscribe
OR

Subscribe by RSS

Add our RSS to your feedreader to get regular updates from us.
Subscribe