Health care costs of incidental durotomies and postoperative cerebrospinal fluid leaks after elective spinal surgery.

Weber, Clemens; Piek, Jürgen; Gunawan, David

PURPOSE To explore the additional health care costs of incidental durotomies and cerebrospinal fluid (CSF) leaks after elective surgery for degenerative spinal disorders. METHODS Prospective, observational single-center study including all patients operated for a degenerative condition of the spine over a 13-month period. Incidental durotomies and cerebrospinal fluid leaks were registered prospectively and a detailed analysis of health care costs of each case was performed. RESULTS In total 239 patients were included; an incidental durotomy occured in ten patients and a postoperative cerebrospinal fluid leak occured in one patient causing significantly higher hospital costs, as well as significantly longer hospital stay and operation time. While the hospital costs increased by nearly 50% the hospitals reimbursement increased only by 21% and this resulted in an average financial loss of 730 per case. CONCLUSION Incidental durotomy or postoperative cerebrospinal fluid leak after elective surgery for degenerative spinal disorders causes significantly higher health care costs.