Aim. The aim of this study is to evaluate the causes of litigation in spinal surgery and to identify preventable causes. Methods. Retrospective analysis of all claim data made available under Freedom of information act from NHS Litigation Authority between years 2000 to 2010. Results. A total of 581 (331 Orthopaedics and 250 Neurosurgery) claims were filed in England and Wales, of these 543 cases were settled while 38 cases were pending. 371 (69%) of 543 settled resulted in payout but 172 (31%) claims were successfully defended by the NHSLA. Average payout was £63,573 total £ 36935933 maximum payout of £ 1800000). This figure rose to average of £ 95125, (Total £553627720) when defence and claimant costs were included. The allegations categories were 123 failure or delay in diagnosis, 108 intra operative problems, 90 failure or delay in treatment, 45 suboptimal consent and in 40 failure to recognise complications. The successful litigations were result of neurological injury in 143, un necessary operation in 37, avoidable pain in 29, death 15 and Misc 31. Conclusion. Litigation can in part be attributed to the “no win no fee” culture; steps that can be taken to reduce the number of successful claims. Failure or delay in diagnosis and Intra operative problems can partially be attributed to lack of resources and or expertise emphasising the need for spinal surgery to be concentrated in specialist centres. Documented informed consent can also potentially decrease litigation. No conflicts of interest. No funding obtained. This abstract has not been previously published in whole or substantial part nor has it been presented previously at a national meeting