Cerebrospinal Fluid Leaks and Their Management After Anterior Cervical Discectomy and Fusion
| Autor: | Peter Syre, William C. Welch, Peter D. Le Roux, Gordon Baltuch, Leif-Erik Bohman |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Leak Anterior cervical discectomy and fusion Postoperative Complications Lumbar Cerebrospinal fluid Operative report medicine Humans Orthopedics and Sports Medicine Retrospective Studies Cerebrospinal Fluid Leak business.industry Retrospective cohort study Middle Aged medicine.disease Hydrocephalus Surgery Spinal Fusion Treatment Outcome Cervical Vertebrae Female Neurology (clinical) Complication business Diskectomy Follow-Up Studies |
| Zdroj: | Spine. 39:E936-E943 |
| ISSN: | 0362-2436 |
| Popis: | Study design Retrospective medical record review and literature review. Objective To identify cases where a cerebrospinal fluid (CSF) leak occurred during an anterior cervical discectomy and fusion (ACDF) and to create a management algorithm based on the findings. Summary of background data ACDF is a commonly performed spinal operation. It is effective with very low complication rates. One rare complication of ACDF is a CSF leak. There is limited information on the management of CSF leaks after ACDF and management is on a surgeon-by-surgeon basis. Methods We reviewed 3 surgeons' case logs and identified cases where a CSF leak was encountered during ACDF and reviewed the patients' medical records, operative reports and imaging to determine how these leaks were managed. We also performed a PubMed search for articles about the presentation and management of CSF leaks after ACDF. Results Thirteen CSF leaks were identified in 1223 ACDFs, corresponding to a CSF leak rate of 1%. Of these, 9 were successfully treated with intraoperative repair. Postoperative lumbar drainage was used in the remaining 4 patients and was successful in 1 patient. Three patients underwent neck re-exploration and attempted delayed repair. Three patients, including one who was found to have hydrocephalus, ultimately required continuous CSF diversion via shunting. We identified 7 case reports of CSF leak in ADCF in the literature and 1 article that reviewed the prevalence and management of this complication. Conclusion CSF leak after ACDF is an uncommon complication that can usually be repaired. We provide a stepwise management strategy for CSF leaks in ACDF. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|