Our patient ultimately required device removal, direct repair, and replacement with a different prosthesis to treat his CSF leak.Ĭopyright © 2020 Elsevier Inc. He developed a cerebrospinal fluid leak after L5-S1 lumbar total disc replacement. Some reports suggest that the incidence of dural tear during surgery is 0.518 1, 2, 3, 4. His symptoms were exacerbated by activity, worse with sitting, and relieved by ice baths. Cerebrospinal fluid (CSF) leakage is a hazardous complication after spine surgery because it can cause symptoms of intracranial hypotension, meningitis and other complications. Although CSF leakage is rare, we discuss a case of CSF leakage and the diagnosis and management of CSF leakage after lumbar total disc replacement.Ī 25-year-old man had presented with discogenic low back pain caused by degenerative disc disease of 9 years' duration. Also, the presence of fluid leaking from the surgical site after lumbar spinal stenosis back surgery should not only prompt the clinician to entertain the possibility of a surgery-associated cerebrospinal. If you need to urinate, you may need to do so in a. However, following lumbar spinal stenosis surgery, the absence of a headache does not exclude the possibility of a cerebrospinal fluid leak. A spontaneous CSF leak can be caused by a physical trauma or it can be idiopathic. It can increase the risk of infection of the spinal fluid (spinal meningitis). A CSF leak can occur spontaneously or after a lumbar puncture procedure. Most patients are asked to lie down for two hours after the procedure. Leaking spinal fluid may cause a spinal headache. The radiologist will numb the skin by injecting a local anesthetic (numbing) drug using a thin needle. ![]() Nevertheless, several complications have been reported, including, among others, wound infection, vascular injury, retrograde ejaculation, postsympathectomy syndrome, ileus, and cerebrospinal fluid (CSF) leak. Your back will be cleaned with an antiseptic solution and draped with sterile towels. Lumbar total disc replacement is increasingly becoming a more common treatment for discogenic low back pain refractory to conservative measures.
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