title: Evaluation of complication rates of pediatric spinal procedures in which a polyethylene glycol sealant was used.
abstract: OBJECTIVE
  Cerebrospinal fluid leakage following durotomy in spinal surgery can lead to significant patient morbidity and mortality, including meningitis and even death. Usage of a polyethylene glycol (PEG) sealant in combination with standard closure techniques has been shown to be effective in preventing CSF leaks in animal models and adult patients, but the results of its use have not been reported in the pediatric population.
  
  
  METHODS
  A retrospective analysis was performed of pediatric neurosurgery patients (0-18 years of age) treated at The Johns Hopkins Hospital from 2003 to 2010. There were 93 spinal surgery patients identified in whom PEG was applied. The incidence of CSF leakage, meningitis, and neurological injury was recorded. There were 54 males and 39 females in this study with an average age of 8.7 years. Of the identified patients, 16.1%, 28%, and 55.9% underwent surgery in the cervical region, thoracic region, and lumbar region, respectively.
  
  
  RESULTS
  At 90-day follow-up, 5 patients (5.4%) had a CSF leak, 4 patients (4.3%) required a reoperation, and 1 patient (1.1%) had meningitis within this time period. No deaths or associated neurological deficits were observed.
  
  
  CONCLUSIONS
  The use of a PEG sealant to augment dural closure in pediatric spine surgery appears to be a safe adjunct to standard dural closure in pediatric spine patients.
authors.affiliation: Division of Pediatric Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
authors.forename: C Rory
authors.initials: CR
authors.lastname: Goodwin
authors.forename: Pablo F
authors.initials: PF
authors.lastname: Recinos
authors.forename: Xin
authors.initials: X
authors.lastname: Zhou
authors.forename: Jesse X
authors.initials: JX
authors.lastname: Yang
authors.forename: George I
authors.initials: GI
authors.lastname: Jallo
mesh_terms: D000293:Adolescent; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology* / Q000517:prevention & control* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004388:Dura Mater / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008581:Meningitis / Q000209:etiology; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods*; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D012086:Reoperation; D012189:Retrospective Studies; D013131:Spine / Q000601:surgery*; D013501:Surface-Active Agents / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D013501:Surface-Active Agents; D011092:Polyethylene Glycols