Management of Persistent Cerebrospinal Fluid Leakage Following Thoraco-lumbar Surgery
Asian Spine Journal
;
: 157-162, 2012.
Artigo
em Inglês
| WPRIM
| ID: wpr-68128
ABSTRACT
STUDY DESIGN:
This was a retrospective study of patients who had developed a dural tear after thoracic and lumbar spine surgery that was not recognized during the surgery, and was treated either by lumbar drainage or over-sewing of the wounds.PURPOSE:
To revisit the treatment strategies in postoperative dural leaks and present our experience with over-sewing of the wound and lumbar drainage. OVERVIEW OF LITERATURE Unintended durotomy is a frequent complication of spinal surgery. Management of subsequent cerebrospinal fluid leakage remains controversial. There is no distinct treatment guideline according to the etiology in the current literature.METHODS:
The records of 368 consecutive patients who underwent thoracic and/or lumbar spine surgery from 2006 throug h 2010 were retrospectively reviewed. Seven cerebrospinal fluid fistulas and five pseudomeningoceles were noted in 12 (3.2%) procedures. Cerebrospinal fluid diversion by lumbar drainage in five pseudomeningoceles and over-sewing of wounds in seven cerebrospinal fluid fistulas employed in 12 patients. Clinical grading was evaluated by Wang.RESULTS:
Of the 12 patients who had a dural tear, 5 were managed successfully with lumbar drainage, and 7 with oversewing of the wound. The clinical outcomes were excellent in 9 patients, good in 2, and poor in 1. Complications such as neurological deficits, or superficial or deep wound infections did not develop. A recurrence of the fistula or pseudomeningocele after the treatment was not seen in any of our patients.CONCLUSIONS:
Pseudomeningoceles respond well to lumbar drainage, whereas over-sewing of the wound is an alternative treatment option in cerebrospinal fluid fistulas without neurological compromise.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Recidiva
/
Coluna Vertebral
/
Cicatrização
/
Infecção dos Ferimentos
/
Drenagem
/
Estudos Retrospectivos
/
Fístula
Tipo de estudo:
Guia de Prática Clínica
/
Estudo observacional
Limite:
Humanos
Idioma:
Inglês
Revista:
Asian Spine Journal
Ano de publicação:
2012
Tipo de documento:
Artigo
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