Management of cerebrospinal fluid leakage after spine surgery extending to the subcutaneous lesion: Should additional surgical treatment be performed?

Abstract

Introduction: To investigate the treatment and natural course of extensive cerebrospinal fluid (CSF) after spine surgery.

Methods: Eight patients (two females and six males) who underwent spine surgery and exhibited extensive CSF after surgery between April 2010 and March 2020 at a single institution were retrospectively reviewed.

Results: Surgical sites were the cervical spine in five patients and the lumbar spine in three patients. In seven of eight patients, incidental durotomy occurred intraoperatively; incidental durotomy did not occur in one patient. Intraoperative dural repair with suture was not performed in three patients. Additional surgical wound exploration was performed in three patients with symptomatic neurological deterioration or deep infection. In the remaining five asymptomatic patients, CSF improved spontaneously.

Conclusion: Asymptomatic patients with extensive CSF may be able to be treated conservatively.