Not repairing a rent/hole in the dura leads to the nerve roots outpouching through the hole in the dura and being injured further. It also leads to a cerebrospinal fluid (CSF) collection pushing on the nerve roots and the remainder of the nerves. By this mechanism, patient may develop a foot drop. MRI may show a fluid leak compressing the thecal sac and nerves at the affected level and side.
An intraoperative maneuver is required to test for a CSF leak when a rent in the dura is known to be present. The nerve roots will outpouch through the hole in the dura unless this maneuver is performed.
Repair of dural rent/hole medical expert witness specialties include neurosurgery, neurology, anesthesiology, and obstetric anesthesiology.