Cerebrospinal Fluid Leak and Symptomatic Pseudomeningocele After Intradural Spine Surgery

World Neurosurgery
Jonathan N SellinAllan D Levi

Abstract

To describe the incidence of and characterize risk factors for cerebrospinal fluid leak and symptomatic pseudomeningocele (CSFL/SP) after intradural spine surgery. A retrospective analysis of a prospectively collected and consecutive series of patients undergoing intradural spine surgery by the senior author (A.D.L.) was conducted over a period of 20 years. Data on 460 surgeries performed on 430 consecutive patients were gathered. The incidence of CSFL/SP formation was 2.8% (n = 13). Of the 13 cases complicated by CSFL/SP, 4 were successfully managed nonoperatively (4/13, 31%); 9 postoperative CSFL/SP required surgical repair (9/13, 69%), making for an overall postoperative surgical repair rate of 1.9% (9/460). Factors significantly related to development of postoperative CSFL/SP on the Fisher exact test were surgery located at the craniocervical junction (risk ratio [RR] 2.7, P = 0.03) and use of any external cerebrospinal fluid drain (any drain: RR 2.5, P = 0.02; lumbar drain specifically: RR 2.6, P = 0.02), the latter finding most likely being attributable to selection bias. No significant difference was observed between primary dural closure and closure incorporating the use of one or more dural repair adjuncts. In addition...Continue Reading

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Citations

Jul 31, 2021·World Neurosurgery·Yulong WangXiaodong Guo

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