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Management of Cerebrospinal Fluid Leakage by Pump-Regulated Volumetric Continuous Lumbar Drainage Following Anterior Cervical Decompression and Fusion for Ossification of the Posterior Longitudinal Ligament – Lumbar Spinal Stenosis

The article discusses a management algorithm for cerebrospinal fluid (CSF) leakage following anterior cervical decompression and fusion for ossification of the posterior longitudinal ligament (OPLL). The proposed algorithm involves the use of pump-regulated volumetric continuous lumbar drainage. The study retrospectively reviewed patients who underwent the procedure and were managed with the algorithm. Of the 14 patients who experienced CSF leakage, 9 underwent lumbar drain insertion according to the algorithm and 8 of them had successful resolution of CSF leakage. The algorithm was found to be safe and effective in managing CSF leakage in this context

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Published article

CONCLUSION: The proposed management algorithm with pump-regulated volumetric continuous lumbar drainage showed safety and efficacy for management of CSF leakage following anterior decompression and fusion for OPLL.

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Neurospine. 2023 Dec;20(4):1421-1430. doi: 10.14245/ns.2346736.368. Epub 2023 Dec 31.ABSTRACTOBJECTIVE: Cerebrospinal fluid (CSF) leakage is a major concern related to anterior cervical decompression and fusion for ossification of the posterior longitudinal ligament (OPLL). We propose a management algorithm for CSF leakage following anterior cervical decompression and fusion for OPLL involving the use of pump-regulated volumetric continuous,

Neurospine. 2023 Dec;20(4):1421-1430. doi: 10.14245/ns.2346736.368. Epub 2023 Dec 31.

ABSTRACT

OBJECTIVE: Cerebrospinal fluid (CSF) leakage is a major concern related to anterior cervical decompression and fusion for ossification of the posterior longitudinal ligament (OPLL). We propose a management algorithm for CSF leakage following anterior cervical decompression and fusion for OPLL involving the use of pump-regulated volumetric continuous lumbar drainage.

METHODS: We retrospectively reviewed patients who underwent anterior cervical decompression and fusion for OPLL and were managed with the proposed algorithm between March 2018 and July 2022. The proposed management algorithm for CSF leakage by pump-regulated volumetric continuous lumbar drainage was as follows. On exposure of the arachnoid membrane with or without CSF leakage, a dural sealant patch was applied to manage the dural defect. In case of persistent CSF leakage despite application of the dural sealant patch, patients underwent pump-regulated volumetric continuous lumbar drainage.

RESULTS: Fifty-one patients were included in the study. CSF leakage occurred in 14 patients. Of these 14 patients, 9 patients underwent lumbar drain insertion according to the proposed management algorithm. Successful resolution of CSF leakage was observed in 8 of the 9 patients who underwent lumbar drainage. All patients were encouraged to ambulate without concern of CSF overdrainage due to gravity, because it could be avoided with pump-regulated volumetric continuous CSF drainage. Therefore, complications associated with absolute bed rest or CSF overdrainage were not observed.

CONCLUSION: The proposed management algorithm with pump-regulated volumetric continuous lumbar drainage showed safety and efficacy for management of CSF leakage following anterior decompression and fusion for OPLL.

PMID:38171308 | DOI:10.14245/ns.2346736.368

The London Spine Unit : best recognised spinal facility in UK

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Management of Cerebrospinal Fluid Leakage by Pump-Regulated Volumetric Continuous Lumbar Drainage Following Anterior Cervical Decompression and Fusion for Ossification of the Posterior Longitudinal Ligament

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Neurospine. 2023 Dec;20(4):1421-1430. doi: 10.14245/ns.2346736.368. Epub 2023 Dec 31.ABSTRACTOBJECTIVE: Cerebrospinal fluid (CSF) leakage is a major concern related to anterior cervical decompression and fusion for ossification of the posterior longitudinal ligament (OPLL). We propose a management algorithm for CSF leakage following anterior cervical decompression and fusion for OPLL involving the use of pump-regulated volumetric continuous

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