Does the Incidency Duraplasty with Synthetic Dural Graft or Standard Primary Dural Closure reduce the risk of retethering? A comparative analysis of 36 pediatric patients

Abstract Bacground; Spinal lipomas in pediatric patients pose a significant risk of neurological deterioration due to the potential for retethering after surgical excision. This study aims to assess the efficacy of duraplasty in mitigating the risk of retethering following spinal lipoma excision in pediatric patients. We compared outcomes between two groups: one treated with duraplasty using synthetic dura and another with primary dural closure. Methods A retrospective analysis was performed on 36 pediatric patients who underwent spinal lipoma excision between 2019 and 2024. Group 1 (n=15) received duraplasty with synthetic dura, while Group 2 (n=21) underwent primary dural closure. The primary outcome was the incidence of retethering, defined by clinical and radiological criteria, over a follow-up period averaging 2.6 years (range: 2 – 5 years). Results A total of 36 pediatric patients with spinal lipomas were included in this retrospective analysis. The mean age of the study cohort was 9 years and 3 months, ranging from 25 days to 18 years Group 1 demonstrated a significantly lower incidence of retethering (13.3%) compared to Group 2 (38.1%), with a p-value of 0.02. The mean time to retethering was also significantly longer in Group 1 (3.5 years) versus Group 2 (2.1 years), with a p-value of 0.045. Conclusion Duraplasty with synthetic dura may reduce the risk of retethering in pediatric patients undergoing spinal lipoma excision. However, further prospective studies with larger sample sizes are required to validate these findings.