Efficacy of intraoperative lumbar subarachnoid drainage for prevention of cerebrospinal fluid leak after spinal cord tumor resection

2018 ◽  
Vol 23 (2) ◽  
pp. 266-272 ◽  
Author(s):  
Kazuyoshi Kobayashi ◽  
Kei Ando ◽  
Kenyu Ito ◽  
Mikito Tsushima ◽  
Akiyuki Matsumoto ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Cerebrospinal Fluid Leak ◽  
Fluid Leak

Delayed cerebrospinal fluid leak after penetrating cervical trauma

Trauma ◽  
2016 ◽  
Vol 19 (1) ◽  
pp. 63-65 ◽  
Author(s):  
Charles Fredericks ◽  
James R Yon ◽  
John Kubasiak ◽  
Anupam Basu ◽  
Kimberly Nagy ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Stab Wound ◽  
Cervical Spinal Cord ◽  
Cerebrospinal Fluid Leak ◽  
Resonance Imaging ◽  
Cervical Trauma ◽  
Cord Injury ◽  
Cerebrospinal Fluid Leaks ◽  
Fluid Leak

Stab wound injury to the cervical spinal cord is a rare occurrence and usually presents with immediate, disastrous, and permanent neurological consequences. Rarer, and potentially as severe, is the complication of a delayed cerebrospinal fluid leak following a stab wound to the cervical spine. In this case, magnetic resonance imaging demonstrates a cerebrospinal fluid leak that extends to the skin with injury to the posterior dura at the C1/C2 level. Epidemiology and management of penetrating cervical spinal cord injury and delayed cerebrospinal fluid leaks are discussed.

Short-term Progressive Spinal Deformity Following Laminoplasty Versus Laminectomy for Resection of Intradural Spinal Tumors

Neurosurgery ◽  
2010 ◽  
Vol 66 (5) ◽  
pp. 1005-1012 ◽  
Author(s):  
Matthew J. McGirt ◽  
Giannina L. Garcés-Ambrossi ◽  
Scott L. Parker ◽  
Daniel M. Sciubba ◽  
Ali Bydon ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Spinal Deformity ◽  
Tumor Resection ◽  
Cerebrospinal Fluid Leak ◽  
Neurological Function ◽  
Spinal Tumors ◽  
Short Term ◽  
Intradural Tumor ◽  
Fluid Leak

Abstract OBJECTIVE Gross total resection of intradural spinal tumors can be achieved in the majority of cases with preservation of long-term neurological function. However, postoperative progressive spinal deformity complicates outcome in a subset of patients after surgery. We set out to determine whether the use of laminoplasty (LP) vs laminectomy (LM) has reduced the incidence of subsequent spinal deformity following intradural tumor resection at our institution. METHODS We retrospectively reviewed the records of 238 consecutive patients undergoing resection of intradural tumor at a single institution. The incidence of subsequent progressive kyphosis or scoliosis, perioperative morbidity, and neurological outcome were compared between the LP and LM cohorts. RESULTS One hundred eighty patients underwent LM and 58 underwent LP. Patients were 46 ± 19 years old with median modified McCormick score of 2. Tumors were intramedullary in 102 (43%) and extramedullary in 102 (43%). All baseline clinical, radiographic, and operative variables were similar between the LP and LM cohorts. LP was associated with a decreased mean length of hospitalization (5 vs 7 days; P = .002) and trend of decreased incisional cerebrospinal fluid leak (3% vs 9%; P = .14). Following LP vs LM, 5 (9%) vs 21 (12%) patients developed progressive deformity (P = .728) a mean of 14 months after surgery. The incidence of progressive deformity was also similar between LP vs LM in pediatric patients < 18 years of age (43% vs 36%), with preoperative scoliosis or loss of cervical/lumbar lordosis (28% vs 22%), or with intramedullary tumors (11% vs 11%). CONCLUSION LP for the resection of intradural spinal tumors was not associated with a decreased incidence of short-term progressive spinal deformity or improved neurological function. However, LP may be associated with a reduction in incisional cerebrospinal fluid leak. Longer-term follow-up is warranted to definitively assess the long-term effect of LP and the risk of deformity over time.

Ultrasonic BoneScalpel for Osteoplastic Laminoplasty in the Resection of Intradural Spinal Pathology: Case Series and Technical Note

2012 ◽  
Vol 73 (suppl_1) ◽  
pp. ons61-ons66 ◽  
Author(s):  
Scott L. Parker ◽  
Ryan M. Kretzer ◽  
Pablo F. Recinos ◽  
Camilo A. Molina ◽  
Jean-Paul Wolinsky ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Case Series ◽  
Central Valley ◽  
Cerebrospinal Fluid Leak ◽  
Technical Note ◽  
Johns Hopkins Hospital ◽  
Incidental Durotomy ◽  
Fluid Leak

Abstract BACKGROUND: Osteoplastic laminoplasty is a well-described technique that may decrease the incidence of progressive kyphosis when used in the setting of intradural spinal cord tumor resection. OBJECTIVE: The BoneScalpel by Aesculap (Central Valley, Pennsylvania) is an ultrasonic osteotome that precisely cuts bone while preserving the underlying soft tissues, potentially reducing the risk of dural laceration during laminoplasty. By producing osteotomies as narrow as 0.5 mm, the device may also facilitate postoperative osteointegration. METHODS: A retrospective analysis was conducted of 40 patients (mean age, 38.0 years; range, 4.0-79.7 years) who underwent osteoplastic laminoplasty using the BoneScalpel for the treatment of intradural spinal pathology at the Johns Hopkins Hospital between January 2009 and December 2011. After lesion resection, titanium plates were used to reconstruct the lamina in all cases. The technical results and procedure-related complications were subsequently noted. RESULTS: Successful laminoplasty was carried out in all 40 patients. Intraoperatively, 1 case of incidental durotomy was noted after use of the device, which was repaired primarily without neurological or clinical sequelae. During the follow-up period (mean, 195 days; median, 144 days), there were 2 complications (1 cerebrospinal fluid leak, 1 seroma) and no cases of immediate postoperative instability. CONCLUSION: The BoneScalpel is a safe and technically feasible device for performing osteoplastic laminoplasty.

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