Delayed herniation of cauda equina root through occult dural tear following unilateral biportal endoscopic decompression: illustrative case

This case highlights the importance of considering dural pathology as a potential cause of intractable postoperative radicular pain, even when perioperative findings are inconclusive. Continuous irrigation can compress the dura, mask small dural tears, or tamponade minor leaks, delaying recognition. Surgeons should be aware that UBE's technical environment carries a risk of undetected dural injuries. Prompt recognition and repair of dural defects are essential to prevent rare but serious complications like cauda equina herniation. https://thejns.org/doi/10.3171/CASE25438.