Journal article
Cerebrospinal fluid leaks following spinal surgery: use of fat grafts for prevention and repair. Technical note
Journal of neurosurgery, v 96(2 Suppl)
Mar 2002
PMID: 12450290
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Cerebrospinal fluid (CSF) leaks are relatively common following spinal surgery. A midline dural tear in the spine is readily repaired by direct application of sutures; however, far-lateral or ventral dural tears are problematic. Fat is an ideal sealant because it is impermeable to water. In this paper the author reports his experience with using fat grafts for the prevention or repair of CSF leaks and proposes a technique in which a large sheet of fat, harvested from the patient's subcutaneous layer, is used to cover not only the dural tear(s) but all of the exposed dura and is tucked into the lateral recess. This procedure prevents CSF from seeping around the fat, which may be tacked to the dura with a few sutures. Fibrin glue is spread on the surface of the fat and is further covered with Surgicel or Gelfoam. For ventral dural tears (associated with procedures in which disc material is excised), fat is packed into the disc space to seal off the ventral dural leak. Dural suture lines following spinal intradural exploration are prophylatically protected from CSF leakage in the same manner. With one exception, 27 dural tears noted during 1650 spinal procedures were successfully repaired using this technique. There was one case of postoperative CSF leakage in 140 cases in which intradural exploration for tumor or other lesions was undertaken. Both postoperative CSF leaks were controlled by applying additional skin sutures. The use of a fat graft is recommended as a rapid, effective means of prevention and repair of CSF leaks following spinal surgery.
Metrics
12 Record Views
Details
- Title
- Cerebrospinal fluid leaks following spinal surgery: use of fat grafts for prevention and repair. Technical note
- Creators
- Perry Black - Hahnemann University Hospital
- Publication Details
- Journal of neurosurgery, v 96(2 Suppl)
- Resource Type
- Journal article
- Language
- English
- Web of Science ID
- WOS:000174177000016
- Scopus ID
- 2-s2.0-0036123287
- Other Identifier
- 991019319083304721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Surgery