Intraoperative durotomy has been associated with chronic post-operative pain in the medical literature. Mechanisms described include direct injury to the nerve at the time of the durotomy, formation of arachnoiditis and mechanical entrapment of the nerve rootlets by herniation through a dural defect. The clinical course may be complicated by postoperative meningitis and osteomyelitis. Postoperative spinal infections and meningitis have also been associated with development of arachnoiditis and chronic pain.
Intraoperative durotomy medical expert witness specialties include neurosurgery, orthopaedic spine surgery, neurology, pain medicine, and radiology.