title: Subarachnoid-pleural fistula: applied anatomy of the thoracic spinal nerve root.
abstract: Subarachnoid-pleural fistula (SPF) is a rare complication of chest or spine operations for neoplastic disease. Concomitant dural and parietal pleural defects permit flow of cerebrospinal fluid into the pleural cavity or intrapleural air into the subarachnoid space. Dural injury recognized intraoperatively permits immediate repair, but unnoticed damage may cause postoperative pleural effusion, intracranial hypotension, meningitis, or pneumocephalus. We review two cases of SPF following surgical intervention for chest wall metastatic disease to motivate a detailed review of the anatomy of neural, osseous, and ligamentous structures at the intervertebral foramen. We further provide recommendations for avoidance and detection of such complication.
authors.affiliation: Division of Neurosurgery, The Ottawa Hospital, Ottawa, ON, Canada K1Y 4E9.
authors.forename: Mohammed F
authors.initials: MF
authors.lastname: Shamji
authors.forename: Sudhir
authors.initials: S
authors.lastname: Sundaresan
authors.forename: Vasco
authors.initials: V
authors.lastname: Da Silva
authors.forename: Jean
authors.initials: J
authors.lastname: Seely
authors.forename: Farid M
authors.initials: FM
authors.lastname: Shamji
references.citation: Chest. 1972 Feb;61(2):189-90
references.pmid: 5058902
references.citation: Acta Neurochir (Wien). 2005 May;147(5):561-4;discussion 564
references.pmid: 15592884
references.citation: Ann Thorac Surg. 1999 Aug;68(2):566-8
references.pmid: 10475434
references.citation: J Thorac Cardiovasc Surg. 1980 Jul;80(1):21-4
references.pmid: 7382531
references.citation: Aust N Z J Med. 1982 Feb;12(1):67-9
references.pmid: 6952843
references.citation: Neurosurgery. 1993 Dec;33(6):1104-8
references.pmid: 8133999
references.citation: Chest. 1998 Dec;114(6):1786-9
references.pmid: 9872224
references.citation: Chest. 2003 Apr;123(4):1280-3
references.pmid: 12684322
references.citation: J Manipulative Physiol Ther. 1994 Oct;17(8):517-22
references.pmid: 7836874
references.citation: J Neurol Sci. 2003 Jan 15;206(1):85-90
references.pmid: 12480090
references.citation: Clin Chem. 1993 Jul;39(7):1444-5
references.pmid: 8330405
references.citation: Chest. 2002 Dec;122(6):2252-6
references.pmid: 12475874
references.citation: Otolaryngol Clin North Am. 2005 Aug;38(4):569-76
references.pmid: 16005717
references.citation: J Neurol. 2001 Dec;248(12):1101-3
references.pmid: 12013592
references.citation: Neurosurgery. 1982 Dec;11(6):795-6
references.pmid: 7162573
references.citation: Spine (Phila Pa 1976). 1997 Jul 15;22(14):1553-6; discussion 1557
references.pmid: 9253087
references.citation: Ann Thorac Surg. 1996 Dec;62(6):1622-6
references.pmid: 8957362
references.citation: Respiration. 2003 Jul-Aug;70(4):423-5
references.pmid: 14512681
references.citation: Spine (Phila Pa 1976). 2001 Aug 15;26(16):1809-13
references.pmid: 11493856
references.citation: Brain. 1968;91(4):707-20
references.pmid: 5304069
references.citation: Childs Brain. 1979;5(1):45-50
references.pmid: 446194
references.citation: Reg Anesth Pain Med. 1999 Jul-Aug;24(4):303-10
references.pmid: 10445768
references.citation: Clin Chest Med. 2006 Jun;27(2):285-308
references.pmid: 16716819
references.citation: Jpn J Thorac Cardiovasc Surg. 2005 Feb;53(2):93-6
references.pmid: 15782571
references.citation: J Neurol Neurosurg Psychiatry. 1982 May;45(5):457-60
references.pmid: 7086458
references.citation: Neuroradiology. 1976 Sep 21;11(5):221-8
references.pmid: 980235
references.citation: J Neurosurg. 1992 Nov;77(5):737-9
references.pmid: 1403116
references.citation: Neurosurgery. 1995 Nov;37(5):908-14
references.pmid: 8559339
references.citation: Am J Physiol Regul Integr Comp Physiol. 2001 Sep;281(3):R909-16
references.pmid: 11507008
references.citation: Clin Orthop Relat Res. 1991 Mar;(264):184-8
references.pmid: 1997234
references.citation: Eur J Pediatr Surg. 2002 Dec;12 Suppl 1:S6-11
references.pmid: 12541207
references.citation: J Spinal Disord. 2001 Feb;14(1):39-45
references.pmid: 11242273
references.citation: Neurosurgery. 1981 Aug;9(2):185-9
references.pmid: 7266820
references.citation: Chest. 1999 Aug;116(2):584-5
references.pmid: 10453900
references.citation: J Appl Physiol (1985). 1988 Jan;64(1):384-90
references.pmid: 3356657
references.citation: Ann Thorac Surg. 1995 Jan;59(1):234-6
references.pmid: 7818338
references.citation: Clin Nucl Med. 1999 Dec;24(12):985-6
references.pmid: 10595487
references.citation: Iowa Orthop J. 2004;24:115-8
references.pmid: 15296217
references.citation: J Neurosurg. 2004 Apr;100(4 Suppl Spine):332-6
references.pmid: 15070140
references.citation: Neuroradiology. 1991;33(1):83-4
references.pmid: 2027456