title: Management of CSF leak following spinal surgery.
abstract: OBJECTIVE
  Postoperative CSF leak is a known complication of spinal surgery especially after surgery for neural tube defects (NTD). The problem can metamorphose into a severe infection. This article hopes to shed some light on the management of these problems and suggests precautions so as to reduce their occurrence.
  
  
  METHODS
  A retrospective analysis of 102 children, between the ages of 1 day and 12 years, operated for various spinal pathologies, over the past 2.5 years by the same surgeon (CB) was done. The various methods of dural closure were noted. The methods of management of postoperative CSF leaks were analysed, and the patients were followed till discharge.
  
  
  RESULTS
  The incidence of CSF leak was found to be 12.7%. The methods of management included lumbar drain only (n = 7), lumbar drain with re-exploration (n = 3), lumbar drain followed by lumboperitoneal shunt (n = 2) and only lumboperitoneal shunt (n = 1). The use of fibrin glue did not seem to significantly prevent the incidence of CSF leak in cases.
  
  
  CONCLUSIONS
  Primary and meticulous dural closure is sine qua non in preventing postoperative CSF leak. A lumbar drain is a convenient and economical method of managing the problem initially failing which more invasive methods like re-exploration may be employed.
authors.affiliation: Kanchi Kamakoti CHILDS Trust Hospital (KKCTH), 12 A, Nageshwara Road, Nungambakkam, Chennai 34, India, bchidu@gmail.com.
authors.forename: Chidambaram
authors.initials: C
authors.lastname: Balasubramaniam
authors.forename: Santosh Mohan
authors.initials: SM
authors.lastname: Rao
authors.forename: K
authors.initials: K
authors.lastname: Subramaniam
mesh_terms: D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D015718:Fibrin Tissue Adhesive; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000601:surgery
chemical_list: D015718:Fibrin Tissue Adhesive