Continuous Mechanical External Compression for Dural Leaks after Lumbar Spine Surgery by Stitching Pads to the Wound, A Conservative Treatment. Report of Two Cases

Luis Díez-Albero, María Tíscar García-Ortiz, Miguel A. Bañuls-Pattarelli, R. Mulholland, F. Lopez-Prats
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Abstract

Purpose: Description of a non-operative technique for the repair of cerebrospinal (CSF) dural leaks after lumbar spine surgery. Methods: Two patients, thirty-nine and seventy-six years old respectively, were previously operated of lumbar discectomy/decompression, and in the following days developed leakage of clear CSF fluid in their surgical wounds. They were treated by means of stitched pads to their wounds, creating continuous external compression reducing the dead space for the CSF to get in. J Spine Res Surg 2021; 3 (4): 106-112 DOI: 10.26502/fjsrs0035 Journal of Spine Research and Surgery 107 Results: After, one and two weeks respectively and no evidence of leakage the sutures were removed. The patients were reviewed at 3 and 6-months post operation, where no clinical evidence of dural leaks was found and in one the MRI confirm their absence. At the end, the patients were asymptomatic of their original lumbar complaint. Conclusion: An alternative simple technique that avoids the necessity of reoperation in the case of postoperative dural tears.
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腰椎手术后硬脑膜泄漏持续机械外压缝合术的保守治疗。两宗个案报告
目的:描述一种用于腰椎手术后脑脊液(CSF)硬膜泄漏修复的非手术技术。方法:2例患者,分别为39岁和76岁,既往行腰椎间盘切除术/减压手术,术后创面出现透明脑脊液渗漏。他们的治疗方法是缝合在伤口上,创造持续的外部压迫,减少脑脊液进入的死亡空间。脊柱外科杂志;3 (4): 106-112 DOI: 10.26502/fjsrs0035脊柱研究与外科杂志107结果:分别在1周和2周后,没有泄漏的证据,缝合线被拆除。术后3个月和6个月复查患者,未发现硬脑膜渗漏的临床证据,其中1例MRI证实无硬脑膜渗漏。最后,患者的原始腰椎疾病无症状。结论:一种简单的手术方法,避免了术后硬膜撕裂的再次手术。
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