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Dural tear and resultant cerebrospinal fluid leaks after cervical spinal trauma.
- Source :
-
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2014 Aug; Vol. 23 (8), pp. 1772-6. Date of Electronic Publication: 2014 May 14. - Publication Year :
- 2014
-
Abstract
- Purpose: Traumatic cervical spinal cord injuries (SCIs) frequently develop dural tears and resultant cerebrospinal fluid (CSF) leaks. They are not usually identified with advanced imaging, and there are no reports on managing CSF leaks after cervical trauma. Hence, the authors evaluated the incidence of CSF leaks after cervical SCIs and described how to predict and manage CSF leaks.<br />Methods: An observational retrospective study was done confirming intraoperative CSF leaks among 53 patients with anterior cervical surgery after cervical spine trauma between 2004 and 2011.<br />Results: Seven patients (13.2%) had dural tears and resultant CSF leaks intraoperatively (M:F ratio of 6:1; mean age, 44.7 years). An initial poor American Spinal Injury Association (ASIA) scale was significantly associated with CSF leaks (p = 0.009). From magnetic resonance imaging (MRI), disruption of the ligamentum flavum was correlated with CSF leaks (p = 0.02). Intraoperative application of fibrin glue on the operated site, postoperative management through the early removal of the wound drain within the first 24 h and early rehabilitation were performed in patients with CSF leaks without perioperative insertion of a lumbar drain. During the follow-up period, none of the patients developed CSF-leak-related complications.<br />Conclusion: The incidence of CSF leaks after traumatic cervical SCI is relatively higher than that of degenerative cervical spinal surgery. An initial poor neurological status and disruption of the ligamentum flavum on the MRI in patients were predictable factors of dural tears and CSF leaks.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Cerebrospinal Fluid Leak diagnosis
Cervical Vertebrae injuries
Cervical Vertebrae surgery
Dura Mater pathology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neurosurgical Procedures adverse effects
Neurosurgical Procedures methods
Postoperative Complications diagnosis
Postoperative Complications etiology
Retrospective Studies
Young Adult
Cerebrospinal Fluid Leak etiology
Dura Mater injuries
Dura Mater surgery
Spinal Cord Injuries complications
Spinal Cord Injuries surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0932
- Volume :
- 23
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
- Publication Type :
- Academic Journal
- Accession number :
- 24823847
- Full Text :
- https://doi.org/10.1007/s00586-014-3332-9