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Do surgeon credentials affect the rate of incidental durotomy during spine surgery



Incidental durotomy is a potential complication of spinal surgery which can cause a number of intra-operative and post-operative complications. The purpose of this study was to determine if the primary operator’s credentials impacted on the incidence of durotomy intra-operatively.


Prospectively collected data of operator credentials in relation to the incidence of durotomy were acquired from the International Eurospine Tango database. The significance of variability and risk factors between operators was measured using the Chi-squared test.


Data from a total of 3,764 patients were captured from the Tango registry. Of these 162 (4.3 %) had a durotomy. Of the total number of patients, the primary operator was neurosurgical in 1,369 (36.4 %) cases; orthopaedic in 180 (4.8 %) cases; other (pre-certification) in 236 (6.3 %) cases; specialised spine surgeon in 1,741 (46.3 %) cases; 6 cases had missing operator data. cerebrospinal fluid (CSF) leak occurred in 57 (4.16 %) of neurosurgeon-operated cases; 5 (2.78 %) orthopaedic-operated cases; 19 (4.06 %) of other surgeon-operated cases; and 81 (4.65 %) in specialised spine surgeon-operated cases. Using Chi-squared test, the significance of the variation in incidence of CSF leak between primary operator groups was not statistically significant (P = 0.1405).


From the data captured and analysed, the rate of durotomy ranged from 2.78 to 4.65 % between operator groups with a mean rate of 4.3 %. The primary operator credentials do not appear to significantly impact the rate of durotomy in spine surgery.

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  1. Than KD, Wang AC, Etame AB, La Marca F, Park P (2008) Postoperative management of incidental durotomy in minimally invasive lumbar spinal surgery. Minim Invasive Neurosurg 51(5):263–266

    CAS  PubMed  Article  Google Scholar 

  2. McMahon P, Dididze M, Levi AD (2012) Incidental durotomy after spinal surgery: a prospective study in an academic institution. J Neurosurg Spine 17(1):30–36

    PubMed  Article  Google Scholar 

  3. Yoshimasa T, Tetsuro S, Hironori H, Tomomaro K, Eiji T (2013) Incidental durotomy during lumbar spine surgery: risk factors and anatomic locations. J Neurosurg Spine 18(2):165–169

    Article  Google Scholar 

  4. Guerin P, El Fegoun AB, Obeid I, Gille O, Lelong L (2012) Incidental durotomy during spine surgery: incidence, management and complications. A retrospective review. Injury 43(4):397–401

    PubMed  Article  Google Scholar 

  5. Espiritu MT, Rhyne A, Darden BV II (2010) Dural tears in spine surgery. J Am Acad Orthop Surg 18:537–545

    PubMed  Google Scholar 

  6. Brookfield K, Randolph J, Eismont F, Brown M (2008) Delayed symptoms of cerebrospinal fluid leak following lumbar decompression. Orthopedics 31(8):816

    PubMed  Article  Google Scholar 

  7. Thomsen F, Amtoft O, Andersen M, Bøge-Rasmussen T, Jensen TT (2010) Iatrogenic dural lesions in lumbar neural decompressive surgery. Ugeskr Laeger 172(9):688–691

    PubMed  Google Scholar 

  8. Hannallah D, Lee J, Khan M, Donaldson WF, Kang JD (2008) Cerebrospinal fluid leaks following cervical spine surgery. J Bone Joint Surg Am 90(5):1101–1105

    PubMed  Article  Google Scholar 

  9. Röder C, Errico TJ, Spivak JM, Murray M, Protopsaltis T (2012) Hospital for joint diseases participates in international spine registry Spine Tango after successful pilot study. Bull NYU Hosp Jt Dis 70(4):254–258

    PubMed  Google Scholar 

  10. Melloh M, Staub L, Aghayev E, Zweig T, Barz T (2008) The international spine registry Spine Tango: status quo and first results. Eur Spine J 17(9):1201–1209

    PubMed Central  PubMed  Article  Google Scholar 

  11. Zweig T, Mannion AF, Grob D, Melloh M, Munting M (2009) How to Tango: a manual for implementing Spine Tango. Eur Spine J 18(3):312–320

    PubMed Central  PubMed  Article  Google Scholar 

  12. Rout R, Mills RJ (2012) The Spine Tango. A feasibility study: describing its use in a UK hospital. J Bone Joint Surg Br 94:49

    Article  Google Scholar 

  13. Baker G, Cizik A, Bransford R, Bellabarba C, Konodi M (2012) Risk factors for unintended durotomy during spine surgery: a multivariate analysis. Spine J 12(2):121–126

    PubMed Central  PubMed  Article  Google Scholar 

  14. Jankowitz BT et al (2009) Effect of fibrin glue on the prevention of persistent cerebral spinal fluid leakage after incidental durotomy during lumbar spinal surgery. Eur Spine J 18(8):1169–1174

    PubMed Central  PubMed  Article  Google Scholar 

  15. 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. J Bone Joint Surg Am 80(12):1728–1732

    CAS  PubMed  Google Scholar 

  16. Epstein NE (2007) The frequency and etiology of intraoperative dural tears in 110 predominantly geriatric patients undergoing multilevel laminectomy with noninstrumented fusions. J Spinal Disord Tech 20(5):380–386

    PubMed  Article  Google Scholar 

  17. Pechlivanis I et al (2009) Perioperative complication rate of lumbar disc microsurgery depending on the surgeon’s level of training. Cen Eur Neurosurg 70(3):137–142

    CAS  Article  Google Scholar 

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Correspondence to N. J. Murray.

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Murray, N.J., Demetriades, A.K., Rolton, D. et al. Do surgeon credentials affect the rate of incidental durotomy during spine surgery. Eur Spine J 23, 1767–1771 (2014).

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  • Spine surgery
  • Dural tear
  • Durotomy
  • Surgeon credentials
  • Orthopaedic spine surgeon
  • Spinal neurosurgeon