In a prospective cohort study from a randomized clinical trial database (SPORT) Atman Desai *et al.* from the Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire published in the *Neurosurgery Journal* to assess whether incidental durotomy during first-time open decompressive laminectomy for lumbar spinal stenosis impacts long-term outcomes. Incidental durotomy was associated with longer operative times, greater blood loss, and longer hospital stays but did not impact long-term functional outcomes (up to 4 years) such as pain, physical function, or disability scores
Critical Review
This study leverages the robust SPORT dataset, focusing on a sub-cohort of 409 patients with lumbar spinal stenosis undergoing first-time laminectomy. The reported 9% incidence of durotomy aligns with existing literature. Its main strength lies in the long-term follow-up (mean 43.8 months) and standardized outcome measures, including SF-36 and ODI.
However, there are several concerns: