Dong-Hyuk Choi; Ji-Won Lee; Chel-Hwan Kim; Yong-Soo Choi

doi:10.4184/jkss.2016.23.3.171

Journal List > J Korean Soc Spine Surg > v.23(Suppl 1) > 1076101

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Choi, Lee, Kim, and Choi: Indirect Repair with Surgicel® and Fibrin Glue for Postoperative Cerebrospinal Fluid Leakage after Cervical Anterior Foraminotomy - A Case Report -

Case Report

Journal of Korean Spine Surg 2016;23(3):171-176.

Published online: 30 September 2016

DOI: https://doi.org/10.4184/jkss.2016.23.3.171

Indirect Repair with Surgicel^® and Fibrin Glue for Postoperative Cerebrospinal Fluid Leakage after Cervical Anterior Foraminotomy - A Case Report -

Dong-Hyuk Choi, M.D., Ji-Won Lee, M.D., Chel-Hwan Kim, M.D., Yong-Soo Choi, M.D.

Department of Orthopaedic Surgery, Kwangju Christian Hospital, Gwangju, Korea

Corresponding author: Yong-Soo Choi, M.D., Ph.D. Department of Orthopaedic Surgery, Kwangju Christian Hospital, 37, Yangrimro, Nam-gu, Gwangju, Korea TEL: +82-62-650-5064, FAX: +82-62-650-5066 E-mail: stemcellchoi@gmail.com

Received 18 February 201625 February 2016 Accepted 8 August 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A case report.

Objectives

To report a case of indirect repair of cerebrospinal fluid (CSF) leakage after cervical anterior foraminotomy using Surgicel^® and fibrin glue.

Summary of Literature Review

There is no single modality that is best practice for this type of case because it is difficult to apply primary repair for a case of CSF leakage after cervical anterior decompression.

Materials and Methods

A 49-year-old female patient was diagnosed with CSF leakage on the second day after cervical anterior foraminotomy. We performed coverage with Surgicel^® and fibrin glue at the CSF leak site.

Results

The patient was treated with indirect repair of CSF leakage without any complications. The clinical and radiological outcomes were excellent upon follow-up 1 year postoperatively.

Conclusions

Indirect repair using Surgicel^® and fibrin glue is an effective treatment for postoperative CSF leakage after cervical anterior foraminotomy.

Keywords: Cervical spine, Anterior decompression, CSF leakage

REFERENCES

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Fig. 1.

A preoperative magnetic resonance image showed C5-6 foraminal stenosis and C6-7 herniated nucleus pulposus.

Fig. 2.

A postoperative radiograph showed interbody fusion with a cage at C5-6, total disc replacement (TDR) at C6-7, and notably, extensive pretracheal space widening (arrow).

Fig. 3.

(A) Erythematous swelling occurred at the neck. (B) Postoperative computed tomography revealed a 7.8×1.5-cm fluid collection (white ar-row) at the prevertebral area. ∗Hemovac line (block arrow).

Fig. 4.

No CSF leakage was detectable after coverage with Surgicel^® and fibrin glue at C5-6 (arrow).

Fig. 5.

(A) A lateral radiograph on postoperative day 10 shows improvement of the pretracheal space widening (arrow). (B) No specific fluid collection was visible at the prevertebral area on the second postoperative computed tomogram.

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