title: Subarachnoid--pleural fistulae--management with a transdiaphragmatic pedicled greater omental flap: report of two cases.
abstract: METHODS
  This report describes the treatment of chronic subarachnoid--pleural fistulae using a pedicled greater omentum transfer flap.
  
  
  OBJECTIVE
  To describe a new technique for the management of chronic subarachnoid--pleural fistulae resulting from thoracic dural tears.
  
  
  BACKGROUND
  Thoracic dural tears with leakage of cerebral spinal fluid into the pleural space can occur after thoracic spine surgery. The treatment of chronic subarachnoid--pleural fistulae using an omental flap, however, has not been reported.
  
  
  METHODS
  The clinical, radiographic, and surgical details of two cases are described.
  
  
  RESULTS
  Pedicled greater omentum transferred to the thoracic spine was an effective method in the treatment of intractable thoracic dural tears for two patients.
  
  
  CONCLUSIONS
  These cases demonstrate that pedicled greater omentum transferred to the thoracic spine can be a safe and effective technique for the management of intractable thoracic dural tears and their complications.
authors.affiliation: Department of Orthopaedic Surgery, Emory Spine Clinic, Emory University School of Medicine, Atlanta, Georgia, USA. john_heller@emory.org
authors.forename: J G
authors.initials: JG
authors.lastname: Heller
authors.forename: H S
authors.initials: HS
authors.lastname: Kim
authors.forename: G W
authors.initials: GW
authors.lastname: Carlson
mesh_terms: D004388:Dura Mater / Q000293:injuries; D005260:Female; D006801:Humans; D008875:Middle Aged; D009852:Omentum / Q000601:surgery*; D010994:Pleura; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D016156:Respiratory Tract Fistula / Q000209:etiology / Q000601:surgery*; D013346:Subarachnoid Space; D013524:Surgical Flaps; D013514:Surgical Procedures, Operative; D014057:Tomography, X-Ray Computed