Cerebrospinal fluid leaks after spine tumor resection: avoidance, recognition and management

Postoperative Thecal Sac Compression Induced by Hydrogel Dural Sealant after Spinal Schwannoma Removal

“…Cerebrospinal fluid (CSF) leaks are a known, frustrating complication in spinal and cranial surgery. 1,6,13,16) In cases of intradural tumors, dura is opened intentionally, which exposes patients to the risk of CSF leakage, and postoperative CSF leaks can lead to complications, such as delayed healing, wound infection, pseudomeningocele, and meningitis. 1,4,[6][7][8]13,20) The risk of CSF leak has been reported to range from 1% to 21%, depending on the size and location of durotomy.…”

“…1,6,13,16) In cases of intradural tumors, dura is opened intentionally, which exposes patients to the risk of CSF leakage, and postoperative CSF leaks can lead to complications, such as delayed healing, wound infection, pseudomeningocele, and meningitis. 1,4,[6][7][8]13,20) The risk of CSF leak has been reported to range from 1% to 21%, depending on the size and location of durotomy. 1,7,8,13,20) Unintentional durotomy may lead to longer operation times, delayed postoperative mobilization, and nerve root injury or neurological deficit, but the majority of cases of incidental durotomy are identified and resolved during surgery without reoperation or further intervention.…”

“…1,4,[6][7][8]13,20) The risk of CSF leak has been reported to range from 1% to 21%, depending on the size and location of durotomy. 1,7,8,13,20) Unintentional durotomy may lead to longer operation times, delayed postoperative mobilization, and nerve root injury or neurological deficit, but the majority of cases of incidental durotomy are identified and resolved during surgery without reoperation or further intervention. 1,6) Patients undergoing surgical intervention for spinal tumors are particularly prone to postoperative CSF leaks due to many other factors.…”

“…1,7,8,13,20) Unintentional durotomy may lead to longer operation times, delayed postoperative mobilization, and nerve root injury or neurological deficit, but the majority of cases of incidental durotomy are identified and resolved during surgery without reoperation or further intervention. 1,6) Patients undergoing surgical intervention for spinal tumors are particularly prone to postoperative CSF leaks due to many other factors. 1) To address this problem, various agents have been introduced over the years to secure watertight dural repairs.…”

Subfascial drainage and clipping technique for treatment of cerebrospinal fluid leak following spinal surgery

“…Patients who are not diagnosed at the time of surgery or undergo inadequate dural repair may develop a postoperative dural leakage or pseudomeningocele. 3 In 1983, Teplick and Haskin 4 reported a pseudomeningocele incidence of 1.6% detected by computerised tomography imaging among 750 patients who underwent lumbar spinal surgery and remained free of dural leak. When they occur, cutaneous leakage usually develop between the first and seventh days after surgery.…”