Background: Cerebrospinal fluid (CSF) leakage is a complication of intradural spinal surgery and is associated with poor wound healing and infection. The incidence of CSF leak is reported at ∼16% in adults, but little information is available in children.
Purpose: The aim of this study is to determine the CSF leak rate and predisposing factors after intradural pediatric spinal surgeries.
Methods: This study was a retrospective chart review of 638 intradural spinal operations at BC Children's Hospital. CSF leak was defined as pseudomeningocele or CSF leak through incision. Primary operations to untether lipomyelomeningoceles, myelomeningocele/meningocele closure, and Chiari decompressions were excluded.
Results: CSF leaks occurred in 7.1%, with 3% having overt CSF leaks through skin (OCSF leak). CSF leaks, specifically OCSF leaks, were associated with postoperative wound infection (P = 0.0016). Sixteen of 45 cases of CSF leak required reoperation. The type of dural suture used, site of operation, or use of fibrin glue did not affect CSF leak rates. Previous spinal surgery (P < 0.0001), use of dural graft (P = 0.0043), method of dural suturing (P = 0.0023), and procedure performed (P < 0.001) were associated with postoperative CSF leakage. Patients with CSF leak were older than those without leak (98 vs. 72 months, P = 0.002).
Conclusions: Our results provide evidence on intraoperative factors that may predispose to CSF leaks after spinal intradural surgery and may help guide surgical practice. This study confirms that the pediatric population shares many of the same risk factors for CSF leak as in adult populations. Further research is needed to explain how specific factors are associated with CSF leaks.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00381-013-2276-4 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Does Cerebrospinal Fluid Leak in Pituitary Surgery Affect Patient Reported Quality of Life?
Laryngoscope
January 2025
Department of Otolaryngology- Head & Neck Surgery, University of Western Ontario, London, Ontario, Canada.
Background: Endoscopic techniques allow for improved visualization and tumor debulking of pituitary adenomas. More thorough tumor resection, however, can be associated with higher rates of CSF leaks. We set out to determine if CSF leaks influenced patient perceived quality of life outcomes.
View Article and Find Full Text PDFTitanium clips and ligamentum flavum-epidural fat patch graft for midline lumbar durotomy closure in pediatric neurosurgery.
J Neurosurg Pediatr
January 2025
2Norton Children's Hospital and Norton Children's Neuroscience Institute, Norton Healthcare, Louisville; and.
Objective: CSF leaks are a significant source of patient morbidity following intradural spine surgeries. Watertight dural closure is crucial during these procedures to minimize the risk of a CSF leak. This study reports postoperative outcomes and changes in patient management after switching to penetrating titanium clips for dural closure in a large cohort of pediatric patients receiving a tethered cord release (TCR) or a selective dorsal rhizotomy (SDR).
View Article and Find Full Text PDFKeyhole Fenestration for Cerebrospinal Fluid Leaks in the Thoracic Spine: Quantification of Bone Removal and Microsurgical Anatomy.
Oper Neurosurg (Hagerstown)
July 2024
Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.
Background And Objective: A safe working trajectory is mandatory for spinal pathologies, especially in the midline, anterior to the spinal cord. For thoracic cerebrospinal fluid (CSF) leaks, we developed a minimally invasive keyhole fenestration. This study investigates the necessary bone removal for sufficient exposure of different leak types particularly regarding weight-bearing structures.
View Article and Find Full Text PDFUnilateral Versus Bilateral Endoscopic Resection of Olfactory Neuroblastoma: Pooled Analysis From Prospective and Retrospective Multicenter Data.
Int Forum Allergy Rhinol
January 2025
Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA.
Background: Olfactory neuroblastoma (ONB) is a rare sinonasal malignancy primarily treated with surgery. For tumors arising from the olfactory area, traditional treatment involves transcribriform resection of the anterior cranial fossa. Surgery can be performed with unilateral or bilateral resection depending on extent of involvement; however, there are currently no studies comparing outcomes between the two.
View Article and Find Full Text PDFPrevalence and characteristics of microspurs in patients with spontaneous intracranial hypotension compared to the general population.
AJNR Am J Neuroradiol
January 2025
From the Department of Neurosurgery (D.N., L.H., J.G., T.P., R.T.S., A.R., C.M.J.); Department of Neuroradiology (T.D., E.I.P.), Institute of Diagnostic and Interventional Neuroradiology, and Department of Neurology (C.S.), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Department of Neurosurgery (J.B.), Medical Center, University of Freiburg, Freiburg, Germany.
Background And Purpose: In patients diagnosed with spontaneous intracranial hypotension (SIH), microspurs are considered the culprit lesion in most ventral dural leaks (type I). The imaging characteristics of discogenic spurs, and their prevalence in the general population has not been reported in the literature.
Materials And Methods: This observational case-control study was conducted comparing the prevalence and characteristics of discogenic microspurs between SIH patients with a type I leak treated at a tertiary hospital between 2013 and 2023 and an age-and sex matched cohort of trauma patients.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!