A short review on a complication of lumbar spine surgery: CSF leak

Clin Neurol Neurosurg. 2015 Dec;139:248-51. doi: 10.1016/j.clineuro.2015.10.013. Epub 2015 Oct 23.

Abstract

Cerebrospinal fluid (CSF) leak is a common complication of surgery involving the lumbar spine. Over the past decades, there has been significant advancement in understanding the basis, management and techniques of treatment for post-operative CSF leak following lumbar spine surgery. In this article, we review previous work in the literature on the various factors and technical errors during or after lumbar spine surgery that may lead to this feared complication, the available options of management with focus on the various techniques employed, the outcomes and also to highlight on the current trends. We also discuss the presentation, factors contributing to its development, basic concepts and practical aspects of the management with emphasis on the different techniques of treatment. Different outcomes following various techniques of managing post-operative CSF leak after lumbar spine surgery have been well described in the literature. However, there is currently no most ideal technique among the available options. The choice of which technique to be applied in each case is dependent on each surgeon's cumulative experience as well as a clear understanding of the contributory underlying factors in each patient, the nature and site of the leak, the available facilities and equipment.

Keywords: Dural tear; Lumbar spine surgery; Post-operative cerebrospinal fluid leak.

Publication types

  • Review

MeSH terms

  • Cellulose, Oxidized / therapeutic use
  • Cerebrospinal Fluid Leak / complications
  • Cerebrospinal Fluid Leak / diagnosis
  • Cerebrospinal Fluid Leak / therapy*
  • Dura Mater / injuries*
  • Fibrin Tissue Adhesive / therapeutic use
  • Gelatin Sponge, Absorbable / therapeutic use
  • Headache / etiology
  • Humans
  • Lumbar Vertebrae / surgery*
  • Myelography
  • Neurosurgical Procedures
  • Postoperative Complications / diagnosis
  • Postoperative Complications / therapy*
  • Reoperation
  • Tissue Adhesives / therapeutic use*
  • Wound Closure Techniques*

Substances

  • Cellulose, Oxidized
  • Fibrin Tissue Adhesive
  • Tissue Adhesives
  • Surgicel