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Postoperative CSF problems after spinal and lumbar surgery. General review.

U Agrillo1, G Simonetti, V Martino

  • 1Department of Neurosurgery of CTO, Rome, Italy.

Journal of Neurosurgical Sciences
|April 1, 1991
PubMed
Summary

Cerebrospinal fluid (CSF) leaks are rare after spinal surgery, especially at the cervical level. This study details the causes, symptoms, diagnosis, and treatment of these uncommon complications.

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Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Neurology

Background:

  • The dura mater is often traumatized during spinal procedures, including surgery for herniated intervertebral discs and lumbar punctures.
  • Despite frequent dural exposure, cerebrospinal fluid (CSF) leaks are rare complications, occurring in approximately 0.1% of surgeries for herniated intervertebral discs.
  • CSF leaks are exceptionally rare at the cervical or dorsal spine levels compared to the lumbar region.

Purpose of the Study:

  • To describe the etiopathology, symptomatology, diagnosis, and treatment of early and delayed cerebrospinal fluid (CSF) problems following spinal interventions.

Main Methods:

  • Review of literature on CSF leaks post-spinal surgery.
  • Analysis of etiological factors contributing to CSF leaks.

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  • Description of diagnostic approaches for identifying CSF leaks.
  • Outline of treatment strategies for both early and delayed CSF complications.

    • Main Results:

    • The incidence of CSF leaks after lumbar disc surgery is surprisingly low (0.1%).
    • Higher CSF pressure in the lumbar region in an upright position may contribute to leak prevalence.
    • Cervical and dorsal CSF leaks are exceptionally rare, potentially due to fewer procedures and greater surgeon expertise at these levels.

    Conclusions:

    • Cerebrospinal fluid (CSF) leaks represent a rare but significant complication in spinal surgery.
    • Understanding the etiopathology and presentation is crucial for timely diagnosis and effective management.
    • This work provides a comprehensive overview to guide clinicians in managing CSF problems.