AANS Neurosurgeon | Volume 29, Number 2, 2020


Durotomy: A Common Complication of Spinal Surgery – and an Important Factor in Some Malpractice Cases

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Incidental durotomy—small tears of the outer membrane of the spinal cord—are a common occurrence in spinal surgery, and may lead to litigation. Most malpractice cases associated with dural tear end in a ruling in favor of the surgeon.

But certain types of durotomy cases are more likely to be resolved in favor of the patient—especially when durotomy is detected late or causes more-severe injury, according to the new research. The lead author is Wesley M. Durand, ScB, a medical student at Brown University, Providence, R.I.

Durotomy in Malpractice Cases – What Factors Affect the Verdict?

In a search of three legal databases, the researchers identified 48 malpractice cases involving “incidental durotomy” during spinal surgery. Incidental durotomy refers to unintended tears or puncture of the dura mater: the tough outer membrane covering the spinal cord. Dural tears occur frequently during spinal surgery; when promptly recognized and repaired, they generally cause no long-term problems.

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