ABSTRACT
One of the most well-known side effects of lumbar spine surgery is dural tears, which can be successfully treated using a variety of methods. Some of the procedures include primary repair, closed subarachnoid drainage, tissue grafting, fibrin-adhesive closure, and bed rest. A new strategy of preventing Cerebrospinal fluid (CSF) leak is employed in this study, which includes post-operative sand bag pressure. Evaluation use sand bag to preventing postoperative CSF leak in lumbar spine surgeries. A prospective study 96 patients at the Hospital. Student t-test and Chi-squared or Fisher Exact’s tests used for CSF leak following various lumbar spine surgeries. Between March 2006 and March 2010, 52 patients were treated using standard treatments, and between March 2010 and March 2013, 44 patients with a post-operative CSF leak were treated with sand bag pressure. Patients in the traditionally treated group mean age 28.33, male to female ratio 11:2, (13.5 percent) ceased CSF leaks on the first day, but those in the post-operative sand bag pressure group mean age 31.32, male to female ratio 10.6:2, (68.2 percent) ceased CSF leaks on the first day. In terms of post-operative complications, the classically treated group had headache (55.7 percent), photophobia (25.0 percent), nausea (32.7 percent), vomiting (15.4 percent), meningitis (5.8 percent), and revision surgery (9.6 percent), whereas the post-operative sand bag pressure group had headache (20.5 percent), photophobia (9.1 percent), nausea (11.4 percent), vomiting (2.3 percent), meningitis (2.3 percent), and revision surgery (0 percent). Sand bag pressure is a great way to shorten the length and severity of a CSF leak.
References
- Yi CT, Yi ST , Chang HO, Chun CL, Hao KW, Hung CK, Shih PH.Treatment, Outcome, and relapse of spontaneous and nonspontaneous cerebrospinal fluid leak, Brain Sci. 2022, 12, 340.
- Eismont, FJ, Wiesel SW, Rothman RH. Treatment of dural tears associated with spinal surgery. Bone and Joint Surg., 63-A: 1132-1136, Sept. 1981.63-A1132 1981.
- Fang Z, Jia YT, Tian R. Subfascial drainage for management of cerebrospinal fluid leakage after posterior spine surgery—a prospective study based on Poiseuille’s law. Chin J Traumatol. 2016; 19:35–38.
- Clarke MJ, Krauss WE. Cerebrospinal fluid happens. World Neurosurg 2015; 83:308-10.
- Lin TY, Chen WJ, Hsieh MK, et al. Postoperative meningitis after spinal surgery: A review of 21 cases from 20,178 patients. BMC Infect Dis 2014;14:220.
- Elder BD, Theodros D, Sankey EW, et al. Management of Cerebrospinal Fluid Leakage During Anterior Cervical Discectomy and Fusion and Its Effect on Spinal Fusion. World Neurosurg 2016; 89:636-40.
- Ghobrial GM, Theofanis T, Darden BV, et al. Unintended durotomy in lumbar degenerative spinal surgery: a 10-year systematic review of the literature. Neurosurg Focus 2015;39:E8.
- Ulrich NH, Burgstaller JM, Brunner F, et al. The impact of incidental durotomy on the outcome of decompression surgery in degenerative lumbar spinal canal stenosis: Analysis of the Lumbar Spinal Outcome Study (LSOS) data-a Swiss prospective multi-center cohort study. BMC Musculoskelet Disord 2016;17:170.
- Adogwa O, Huang MI, Thompson PM, et al. No difference in postoperative complications, pain, and functional outcomes up to 2 years after incidental durotomy in lumbar spinal fusion: A prospective, multi-institutional, propensity-matched analysis of 1,741 patients. Spine J 2014;14:1828-34.
- Serkan E, Emre B, Fırat F. Treatment of postoperative cerebrospinal fluid leakage by blood patch method in patients undergoing vertebra surgery, J Turk Spinal Surg. 2021:32(4):144-7
- Weber C, Piek J, Gunawan D. Health care costs of incidental durotomies and postoperative cerebrospinal fluid leaks after elective spinal surgery. Eur Spine J 2015; 24:2065-8.
- Kasliwal MK, Tan LA, O’Toole JE. Intradural tumor recurrence after resection of extradural metastasis: a rare but potential complication of intraoperative durotomy. J Neurosurg Spine 2014;20:734-9.
- Yanamadala V, Rozman PA, Kumar JI, et al. Vascularized Fibular Strut Autografts in Spinal Reconstruction after Resection of Vertebral Chordoma or Chondrosarcoma: A Retrospective Series. Neurosurgery 2017;81:156-64.
- Tarantino R, Donnarumma P, Nigro L, et al. Surgery of intradural extramedullary tumors: Retrospective analysis of 107 cases. Neurosurgery 2014;75:509-14.
- Yuyu Ishimoto, Mamoru Kawakami, Elizabeth Curtis, et al. The New Strategy for the Treatment of Cerebrospinal Fluid Leak. Spine Surg Relat Res 2020: 95-98
- Following Lumbar SurgeryTurel MK, D’Souza WP, Rajshekhar V. Hemilaminectomy approach for intradural extramedullary spinal tumors: an analysis of 164 patients. Neurosurg Focus 2015;39:E9.
- Wong AP, Lall RR, Dahdaleh NS, et al. Comparison of open and minimally invasive surgery for intradural-extramedullary spine tumors. Neurosurg Focus 2015;39: E11.
- Formo M, Halvorsen CM, Dahlberg D, et al. Minimally invasive microsurgical resection of primary, intradural spinal tumors is feasible and safe: A consecutive series of 83 patients. Neurosurgery 2018; 82: 365-71.
- Wong AP, Shih P, Smith TR, et al. Comparison of symptomatic cerebral spinal fluid leak between patients undergoing minimally invasive versus open lumbar foraminotomy, discectomy, or laminectomy. World Neurosurg 2014; 81: 634-40.
Download all article in PDF
