Cerebrospinal fluid fistula secondary to dural tear in anterior cervical discectomy and fusion: case report.

Abstract:

STUDY DESIGN:A case of cerebrospinal fistula secondary to a dural tear during anterior cervical discectomy and fusion. OBJECTIVES:To report a quite rare complication associated with anterior cervical discectomy and remind the spinal surgeons that this infrequent complication can easily become a very serious one. SUMMARY OF BACKGROUND DATA:Anterior cervical discectomy represents one of the most commonly performed spinal procedures. Of the associated complications, accidental dural tear can lead to the development of a cerebrospinal fluid (CSF) fistula. Although this complication has been mentioned in several clinical series, the body of knowledge regarding incidence and appropriate treatment is definitely limited. METHODS:After undergoing anterior cervical discectomy and fusion for an extruded disc at the C4-C5 level, a CSF fistula developed in a 37-year-old patient as a result of a dural tear. The patient underwent a second procedure for surgical wound revision, meticulous dural opening coverage, and insertion of a lumbar drain for draining CSF for 5 days. RESULTS:The patient was hospitalized for 5 days and then discharged with no evidence of CSF leakage. His follow-up of 9 months revealed complete resolution of his preoperative symptomatology and no other problems associated with the complication of the CSF fistula. CONCLUSION:Early identification of this complication and aggressive treatment with insertion of lumbar drain, CSF drainage for 4-5 days, and coverage of the dural tear with fibrin sealant or autologous fascia graft can prevent the development of any consequences.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Fountas KN,Kapsalaki EZ,Johnston KW

doi

10.1097/01.brs.0000162399.93992.5c

keywords:

subject

Has Abstract

pub_date

2005-05-15 00:00:00

pages

E277-80

issue

10

eissn

0362-2436

issn

1528-1159

pii

00007632-200505150-00028

journal_volume

30

pub_type

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