European Spine Journal

, Volume 14, Issue 3, pp 287–290 | Cite as

Incidental durotomy in lumbar spine surgery: incidence and management

  • Suhayl I TafazalEmail author
  • Philip J Sell
Original Article


There is increasing awareness of the need to inform patients of common complications that occur during surgical procedures. During lumbar spine surgery, incidental tear of the dural sac and subsequent cerebrospinal fluid leak is possibly the most frequently occurring complication. There is no consensus in the literature about the rate of dural tears in spine surgery. We have undertaken this study to evaluate the incidence of dural tears among spine surgeons in the United Kingdom for commonly performed spinal procedures. Prospective data was gathered for 1,549 cases across 14 institutions in the United Kingdom. The results give us a baseline rate for the incidence of dural tears. The rate was 3.5% for primary discectomy, 8.5% for spinal stenosis surgery and 13.2% for revision discectomy. There was a wide variation in the actual and estimated rates of dural tears among the spine surgeons. The results confirm that prospective data collection by spine surgeons is the most efficient and accurate way to assess complication rates for spinal surgery.


Complication rates Incidental durotomy Lumbar spine surgery 


  1. 1.
    Alexander A, Jones M, Stambough JL et al (1989) Long-term results of lumbar spine surgery complicated by unintended incidental durotomy. Spine 14(4):443–446PubMedGoogle Scholar
  2. 2.
    Bosacco SJ, Gardner MJ, Guille JT (2001) Evaluation and treatment of dural tears in lumbar spine surgery—a review. Clin Orthop 389:238–247PubMedGoogle Scholar
  3. 3.
    Camissa FP, Girardi FP, Sangani PK et al (2000) Incidental durotomy in spine surgery. Spine 25(20):2663–2667CrossRefPubMedGoogle Scholar
  4. 4.
    Goodkin R, Laska LL (1995) Unintended “incidental” durotomy during surgery of the lumbar spine: medicolegal implications. Surg Neurol 43:4–12CrossRefPubMedGoogle Scholar
  5. 5.
    Hodges SD, Humphreys CS, Eck JC et al (1999) Management of incidental durotomy without mandatory bed rest: a retrospective review of 20 cases. Spine 24(19):2062–2065CrossRefPubMedGoogle Scholar
  6. 6.
    Torrens MJ, Dickson RA (1991) Operative spinal surgery. Churchill Livingstone, EdinburghGoogle Scholar
  7. 7.
    Oxford Centre for Evidence Based Medicine (2001) Levels of evidence. Cited May 2001
  8. 8.
    Hardy RW (1997) Lumbar discectomy: surgical tactics, chap 90. In: Frymoyer JW (ed) The adult spine, principles and practice, 2nd edn. Lippincott-Raven, Philadelphia Google Scholar
  9. 9.
    Stolke D, Sollmann W, Seifert V (1989) Intra- and postoperative complications in lumbar disc surgery. Spine 14:56–59PubMedGoogle Scholar
  10. 10.
    Wang JC, Bohlman HH, Riew KD (1998) Dural tears secondary to operations on the lumbar spine: management and results after a two-year minimum follow-up of eighty-eight patients. JBJS 80:1728–1732Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Leicester General HospitalUniversity Hospitals LeicesterLeicesterUK

Personalised recommendations