A review of 146 medical malpractice cases involving surgery of the lumbar spine disclosed that unintended "incidental" durotomy (23 cases) was the second most frequently named occurrence. In each instance there was an associated alleged complication or sequelae. There appears to be a subset of patients in whom an unintended "incidental" durotomy is associated with perioperative morbidity and long-term sequelae. Considering the frequency with which a dural tear is listed as one of the complaints in medical malpractice cases involving surgery of the lumbar spine, it cannot be considered an entirely "benign event."