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2017, Number 4

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Rev Mex Anest 2017; 40 (4)

Hemodynamic patch for the management of cerebrospinal fluid fistula postlaminectomy

Méndez-Hernández AZ, Álvarez-Reséndiz GE, Pérez-Tagle CC, Klériga-Grossgerge E, Pérez-Mendizábal JA, Duarte-Pérez KJ, Franco-Cabrera M

Language: Spanish
References: 28
Page: 306-311
PDF size: 270.25 Kb.


ABSTRACT

Introduction: The cerebrospinal fluid leak (CSF) is defined as the loss of continuity of the dura, which generates the leak of CSF to paraspinal tissues. The incidence of this entity after open spine surgery is low and decreases even more in microsurgery procedures. The management objective is to correct the CSF leak. Late submission is rare and is primerily associated with the presence of osseous remains in the surgery field nearby the peridural space. The definitive management is the primary surgical repair, however, other less invasive treatments such as blood patch are reported in the literature with satisfactory results; this has proven to be a good therapeutic tool for CSF leak in recent years. Case report: The case is a 46 female with cerebrospinal fluid leak posterior a L5/S1 laminotomy with microsurgery, presenting this complication after she was discharged from the hospital, a blood patch was placed and absolute rest was given for 48 hours without CSF Leak improvement, so microsurgical correction was decided with good improvement. Discussion: We disccused in this article the different treatment options for CSF leak management, secondary to spinal surgery, including administration of a blood patch, the analysis of failure factors, different techniques and potential complications.


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