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Dural repair refers to the critical surgical procedures used to close or patch defects in the dura mater, the thick, outermost protective membrane surrounding the brain and spinal cord, which is essential for containing the cerebrospinal fluid (**CSF**). Breaches in the dura, often occurring iatrogenically during neurosurgical or spinal procedures, or resulting from trauma, must be meticulously sealed to prevent CSF leakage, which can lead to serious complications such as persistent headaches, infection (meningitis), or formation of a pseudomeningocele. Successful dural repair involves achieving a durable, watertight closure to restore the integrity of the barrier.

The goal of any dural repair is to achieve a watertight primary closure whenever possible. For small, clean tears, this involves a careful, meticulous closure using fine, non-absorbable sutures, often performed under high magnification (using a surgical microscope or specialized loupes). The challenge lies in the thin, delicate nature of the dura mater and the…

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