J Neurol Surg A Cent Eur Neurosurg 2022; 83(01): 066-068
DOI: 10.1055/s-0040-1721020
Technical Note

Step Back in Order to Go Forward: Willful Enlargement and Sandwich Closure Technique for Spinal Dura Repair after Several Unsuccessful Closure Attempts

Maximilian Sitz
1   Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany
,
Sergej Rot
1   Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany
,
Pawel Gutowski
2   Department of Neurosurgery, Brodno Masovian Hospital, Warsaw Postgraduate Medical Centre, Warsaw, Poland
,
Lutz Kreißl
3   Department of Radiology and Neuroradiology, Unfallkrankenhaus Berlin, Berlin, Germany
,
Johannes Lemcke
1   Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany
› Author Affiliations

Abstract

A CSF leak is a common complication in spine surgery which is usually closed effectivly by suture and/or epidural patches. There is currently no algorithm to treat a recurrent CSF leak that fails to be closed initially. We describe the case of a recurrent cerebrospinal fluid leak that we have successfully treated using an inlay-onlay dural repair technique.



Publication History

Received: 29 December 2019

Accepted: 12 March 2020

Article published online:
04 February 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Wang JC, Bohlman HH, Riew KD. Dural tears secondary to operations on the lumbar spine. Management and results after a two-year-minimum follow-up of eighty-eight patients. J Bone Joint Surg Am 1998; 80 (12) 1728-1732
  • 2 Hannallah D, Lee J, Khan M, Donaldson WF, Kang JD. Cerebrospinal fluid leaks following cervical spine surgery. J Bone Joint Surg Am 2008; 90 (05) 1101-1105
  • 3 Menon SK, Onyia CU. A short review on a complication of lumbar spine surgery: CSF leak. Clin Neurol Neurosurg 2015; 139 (December): 248-251
  • 4 Ito K, Aoyama T, Horiuchi T, Hongo K. Utility of nonpenetrating titanium clips for dural closure during spinal surgery to prevent postoperative cerebrospinal fluid leakage. J Neurosurg Spine 2015; 23 (06) 812-819
  • 5 Wong AP, Shih P, Smith TR. et al. Comparison of symptomatic cerebral spinal fluid leak between patients undergoing minimally invasive versus open lumbar foraminotomy, discectomy, or laminectomy. World Neurosurg 2014; 81 (3–4): 634-640
  • 6 Özütemiz C, Köksel YK, Huang H, Rubin N, Rykken JB. The efficacy of fluoroscopy-guided epidural blood patch in the treatment of spontaneous and iatrogenic cerebrospinal fluid leakage. Eur Radiol 2019; 29 (08) 4088-4095
  • 7 Fang Z, Tian R, Jia YT, Xu TT, Liu Y. Treatment of cerebrospinal fluid leak after spine surgery. Chin J Traumatol 2017; 20 (02) 81-83
  • 8 Montano N, Pignotti F, Auricchio AM, Fernandez E, Olivi A, Papacci F. Results of TachoSil® associated with fibrin glue as dural sealant in a series of patients with spinal intradural tumors surgery. Technical note with a review of the literature. J Clin Neurosci 2019; 61 (March): 88-92
  • 9 Brazdzionis J, Ogunlade J, Elia C, Wacker MR, Menoni R, Miulli DE. Effectiveness of method of repair of incidental thoracic and lumbar durotomies: a comparison of direct versus indirect repair. Cureus 2019; 11 (07) e5224
  • 10 Wong AP, Shih P, Smith TR. et al. Comparison of symptomatic cerebral spinal fluid leak between patients undergoing minimally invasive versus open lumbar foraminotomy, discectomy, or laminectomy. World Neurosurg 2014; 81 (3–4): 634-640