Navigated lumbar drain placement: A description of technique and case example

Area of Science:

• Neurosurgery
• Medical Device Technology

Background:

• Lumbar drain (LD) placement is technically challenging, especially in patients with cerebrospinal fluid (CSF) leaks or significant body habitus.
• Complications can arise from difficult LD placement, necessitating improved procedural techniques.

Observation:

• A morbidly obese 18-year-old male, post-Chiari Malformation surgery, developed a pseudomeningocele requiring wound revision and LD placement.
• Medtronic's SureTrak Navigation system was employed for navigated LD placement prior to wound revision.
• The navigated procedure resulted in successful LD placement in a single attempt.

Findings:

• The SureTrak Navigation system facilitated precise LD placement in a complex patient case.
• The patient experienced a favorable postoperative course, with LD removal on postoperative day 6 and no evidence of CSF leak.

Implications:

• Navigated LD placement using the SureTrak system is a viable strategy for patients with high body mass index and persistent CSF leaks.
• Integrating navigation into existing surgical procedures can enhance efficiency and reduce risks for lumbar drain placement.
• This technical approach offers a low-risk intervention, particularly when performed in a single prone positioning during another operative procedure.