Skip Navigation LinksHome > July 15, 2014 - Volume 39 - Issue 16 > Cerebrospinal Fluid Leaks and Their Management After Anterio...
doi: 10.1097/BRS.0000000000000404
Cervical Spine

Cerebrospinal Fluid Leaks and Their Management After Anterior Cervical Discectomy and Fusion: A Report of 13 Cases and a Review of the Literature

Syre, Peter MD; Bohman, Leif-Erik MD; Baltuch, Gordon MD, PhD; Le Roux, Peter MD; Welch, William C. MD

Collapse Box


Study Design. Retrospective medical record review and literature review.

Objective. To identify cases where a cerebrospinal fluid (CSF) leak occurred during an anterior cervical discectomy and fusion (ACDF) and to create a management algorithm based on the findings.

Summary of Background Data. ACDF is a commonly performed spinal operation. It is effective with very low complication rates. One rare complication of ACDF is a CSF leak. There is limited information on the management of CSF leaks after ACDF and management is on a surgeon-by-surgeon basis.

Methods. We reviewed 3 surgeons' case logs and identified cases where a CSF leak was encountered during ACDF and reviewed the patients' medical records, operative reports and imaging to determine how these leaks were managed. We also performed a PubMed search for articles about the presentation and management of CSF leaks after ACDF.

Results. Thirteen CSF leaks were identified in 1223 ACDFs, corresponding to a CSF leak rate of 1%. Of these, 9 were successfully treated with intraoperative repair. Postoperative lumbar drainage was used in the remaining 4 patients and was successful in 1 patient. Three patients underwent neck re-exploration and attempted delayed repair. Three patients, including one who was found to have hydrocephalus, ultimately required continuous CSF diversion via shunting. We identified 7 case reports of CSF leak in ADCF in the literature and 1 article that reviewed the prevalence and management of this complication.

Conclusion. CSF leak after ACDF is an uncommon complication that can usually be repaired. We provide a stepwise management strategy for CSF leaks in ACDF.

Level of Evidence: 5

© 2014 by Lippincott Williams & Wilkins

Follow Us!



Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.