Cerebrospinal fluid leak during cervical corpectomy for ossified posterior longitudinal ligament: incidence, management, and outcome.
METHODS
Retrospective.


OBJECTIVE
To study the incidence of intraoperative cerebrospinal fluid (CSF) leak in patients with ossified posterior longitudinal ligament (OPLL) undergoing central cervical corpectomy (CC) and to describe a reliable technique for treating the leak after CC.


BACKGROUND
The rate of dural tear after CC is higher in patients with OPLL compared to other causes of cervical spinal stenosis. Various techniques have been described to deal with dural tears with CSF leak in OPLL. We assessed the efficacy of the repair technique used to deal with this complication in our patients with OPLL who had undergone CC.


METHODS
A retrospective study was performed of all patients diagnosed with OPLL (n = 144) who had undergone CC between July 1992 and June 2007 (15 years). The dural defect was repaired with an onlay graft of crushed muscle/fascia and a layer of gelatin sponge. Bed rest and a lumbar subarachnoid drain were used for 5 days after surgery.


RESULTS
Intraoperative CSF leak was noted in 9 patients (6.3%). The dural defects ranged in size from a few mm to about 15 mm (10-75 mm). All patients had a successful repair with no patient requiring reoperation for the CSF leak.


CONCLUSIONS
Intraoperative CSF leak was encountered in 6.3% of patients undergoing CC for OPLL. A successful repair was achieved using fascial graft, gelatin sponge, lumbar CSF drainage, and bed rest.
Joseph
Vivek
V
Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, Tamil Nadu.
Kumar
G Samson Sujit
GS
Rajshekhar
Vedantam
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000601:surgery; D004388:Dura Mater / Q000293:injuries*; D005205:Fascia / Q000637:transplantation; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000473:pathology / Q000601:surgery*; D013353:Subdural Effusion / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult