Anterior Thoracic Discectomy and Fusion for Symptomatic Ventral Bone Spur Associated Type I Cerebrospinal Fluid Leak: A Technical Report and Operative Video.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-09-01 Epub Date: 2023-03-04 DOI:10.1177/21925682231161303

Joseph S Hudson, David Fernandes-Cabral, Prateek Agarwal, Andrew Legarreta, Anthony Schulien, Hansen Deng, Vikas Agarwal, David O Okonkwo

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Abstract

Study design: Technical Report.

Objective: Cerebrospinal fluid (CSF) leak secondary to anterior osteophytes at the cervico-thoracic junction is a rare cause of intracranial hypotension. In this article we describe a technique for anterior repair of spontaneous ventral cerebrospinal fluid leaks in the upper thoracic spine.

Methods: In this technical report and operative video, we describe a 23-year-old male who presented with positional headaches and bilateral subdural hematoma. Dynamic CT myelography demonstrated a high flow ventral cerebrospinal fluid leak associated with a ventral osteophyte at the level of the T1-T2 disc space. Targeted blood patch provided only temporary improvement in symptoms. An anterior approach was chosen to remove the offending spur and micro-surgically repair the dural defect.

Results: The patient had complete resolution of his preoperative symptoms after primary repair.

Conclusions: In select cases, an anterior approach to the upper thoracic spine is effective to repair Type 1 cerebrospinal fluid leaks.

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胸椎前路椎间盘切除术和融合术治疗症状性腹侧骨刺伴 I 型脑脊液漏：技术报告和手术视频。

研究设计：技术报告：颈胸交界处前方骨质增生继发的脑脊液（CSF）漏是颅内低血压的罕见原因。本文介绍了上胸椎自发性腹侧脑脊液漏的前路修复技术：在这份技术报告和手术视频中，我们描述了一名 23 岁的男性，他出现位置性头痛和双侧硬膜下血肿。动态 CT 髓造影显示，高流量腹侧脑脊液漏与 T1-T2 椎间盘水平的腹侧骨质增生有关。靶向血液补片只能暂时改善症状。患者选择从前方入路切除骨刺，并通过显微手术修复硬脑膜缺损：结果：患者在初级修复术后完全恢复了术前症状：结论：在特定病例中，上胸椎前方入路可有效修复 1 型脑脊液漏。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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