Abstract
Introduction
Dural tears are most common complications of lumbar spine surgery and have been successfully managed using several techniques. These include primary repair, closed subarachnoid drainage, tissue grafting, fibrin-adhesive sealant, and bed rest. In this study a new method with post operative sand bag pressure to prevent Cerebrospinal fluid (CSF) leak is used.
Methods
A prospective study of 96 patients admitted to the Department of Neurosurgery at the Alsadr Teaching Hospital in Basrah/Iraq had CSF leak following different lumbar spine surgeries. Fifty two patients between March 2006 and March 2010 treated with the classical methods and 44 consecutive patients who had a post operative CSF leak between March 2010 and March 2013 treated with sand bag pressure.
Results
Classically treated group (13.5%) patients stopped CSF leak as compared with post operative sand bag pressure group (68.2%) patients stopped CSF leak in the first day. Regarding post operative complications, classically treated group had headache (55.8%), Photophobia (25.0%), nausea (32.7%), vomiting (15.4%), meningitis (5.8%) and revision surgery (9.6%) while post operative sand bag pressure group had headache (20.5%), Photophobia (9.1%), nausea (11.4%), vomiting (2.3%), meningitis (2.3%) and revision surgery (0%).
Conclusions
and bag pressure is an excellent method to decrease duration and complications of CSF leak.