title: Do surgeon credentials affect the rate of incidental durotomy during spine surgery.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Spinal Surgery, Nuffield Orthopaedic Hospital, Oxford, UK, murraynjj@googlemail.com.
authors.forename: N J
authors.initials: NJ
authors.lastname: Murray
authors.forename: A K
authors.initials: AK
authors.lastname: Demetriades
authors.forename: D
authors.initials: D
authors.lastname: Rolton
authors.forename: C
authors.initials: C
authors.lastname: Nnadi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000592:standards; D003406:Credentialing / Q000592:standards*; D016208:Databases, Factual / Q000592:standards; D004388:Dura Mater / Q000293:injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007431:Intraoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011446:Prospective Studies; D012042:Registries / Q000592:standards; D012307:Risk Factors; D013131:Spine / Q000601:surgery*; D066231:Surgeons / Q000592:standards*; D055815:Young Adult