Universität zu Köln

Lenschow, Moritz, Perrech, Moritz, Telentschak, Sergej, von Spreckelsen, Niklas, Pieczewski, Julia, Goldbrunner, Roland and Neuschmelting, Volker ORCID: 0000-0001-7527-6990 (2022). Cerebrospinal fluid leaks following intradural spinal surgery-Risk factors and clinical management. Front. Surg., 9. LAUSANNE: FRONTIERS MEDIA SA. ISSN 2296-875X

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Abstract

Background: Cerebrospinal fluid leakage (CSFL) following spinal durotomy can lead to severe sequelae. However, while several studies have investigated accidental spinal durotomies, the risk factors and influence of clinical management in planned durotomies remain unclear. Methods: We performed a retrospective analysis of all patients who underwent planned intradural spinal surgery at our institution between 2010 and 2020. Depending on the occurrence of a CSFL, patients were dichotomized and compared with respect to patient and case-related variables as well as dural closure technique, epidural drainage placement, and timing of mobilization. Results: A total of 351 patients were included. CSFL occurred in 4.8% of all cases. Surgical indication, tumor histology, location within the spine, previous intradural surgery, and medical comorbidities were not associated with an increased risk of CSFL development (all p > 0.1). Age [odds ratio (OR), 0.335; 95% confidence interval (CI), 0.105-1.066] and gender (OR, 0.350; 95% CI, 0.110-1.115) were not independently associated with CSFL development. There was no significant association between CSFL development and the dural closure technique (p = 0.251), timing of mobilization (p = 0.332), or placement of an epidural drainage (p = 0.321). Conclusion: CSFL following planned durotomy pose a relevant and quantifiable complication risk of surgery that should be factored in during preoperative patient counseling. Our data could not demonstrate superiority of any particular dural closure technique but support the safety of both early mobilization within 24 h postoperatively and epidural drainage with reduced or no force of suction.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lenschow, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Perrech, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Telentschak, Sergej UNSPECIFIED UNSPECIFIED UNSPECIFIED von Spreckelsen, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Pieczewski, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Neuschmelting, Volker UNSPECIFIED orcid.org/0000-0001-7527-6990 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-658304
DOI:	10.3389/fsurg.2022.959533
Journal or Publication Title:	Front. Surg.
Volume:	9
Date:	2022
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	2296-875X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INCIDENTAL DUROTOMY; BED REST; DRAINAGE; COMPLICATIONS; PROTOCOL; OUTCOMES; RATES Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/65830