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Lateral ventriculo-peritoneal shunt treating delayed cerebrospinal fluid leak after cervical laminoplasty: Case
Wenshan Gao1, Bao Ren, Xiaodong Wang
1Department of Orthopaedics, Affiliated Hospital of Hebei University, Baoding, China.
Rationale:
Delayed cerebrospinal fluid (CSF) leak is a rare and terrible complication after cervical surgery, potentially causing morbidity or even threatening life.
Patient Concerns:
A 55-year-old Chinese male, with a history of hypertension for 8 years, complained of numbness and weakness of both upper limbs for 10 years. Strength of right upper limb triceps and wrist extensor muscle was slight weakness. Bilateral Hoffman sign was positive. Cervical magnetic resonance imaging (MRI) indicated multilevel cervical spondylotic myelopathy. We performed cervical laminoplasty for that patient on August 23, 2018. Nevertheless, he abruptly complained of dizziness and vision, but the wound condition was good. Cervical MRI showed delayed cerebrospinal fluid leak on October 15, 2018.
Diagnoses:
He was diagnosed with delayed CSF leak after cervical laminoplasty.
Interventions:
We performed lateral ventriculo-peritoneal shunt (LVPS) for that patient on October 17, 2018.
Outcomes:
At 3-month follow-up, the treatment has a good outcome and there is no recurrence of clinical symptoms.
Lessons:
Delayed CSF leak after cervical laminoplasty is rare. Once diagnosed, surgery is needed as soon as possible. LVPS has been proven an effective treatment for this server disease.
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