Medicine · 2025
Delayed cerebrospinal fluid leak following lumbar interbody fusion caused by floating lamina: A case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Tang Binbin, Chen Chen, Zhang Han, Feng Junwei, Wu Bing, An Zhongcheng, Dong Liqiang
Аннотация
RATIONALE: Delayed cerebrospinal fluid (CSF) leakage after lumbar interbody fusion are scarce. Known causes include severe spinal canal stenosis and iatrogenic factors. This case presents a unique etiology, highlighting the importance of timely management. Prediction and prevention of postoperative complications is crucial.
PATIENT CONCERNS: We report a 37-year-old woman had recurrent low back pain and radiating right lower extremity pain for 2 years, which had exacerbated over the past week. Imaging revealed mild L5 spondylolisthesis, a free fragment of the L5-S1 lumbar disc, bilateral L5 pars defects (spondylolysis), and floating L5 lamina. Treatment involved L5 right laminectomy and L5-S1 lumbar interbody fusion. On postoperative day 6, the patient developed headache and bulging at the incision site.
DIAGNOSES: Combined with analysis of the aspirated fluid, magnetic resonance imaging indications and patient's symptoms, a diagnosis of delayed CSF leak was made.
INTERVENTIONS: Resection of the remaining and floating L5 left lamina and direct suturation were performed for dural tear repair followed by postoperative drainage tube placement.
OUTCOMES: The patient was discharged with successful recovery 2 weeks after the second surgery. Follow-up lumbar magnetic resonance imaging confirmed resolution of the CSF leak and satisfactory recovery.
LESSONS: In lumbar pathologies with unique anatomy like a floating lamina, vigilance for delayed CSF leak is crucial. Meticulous preoperative imaging review and adaptable surgical strategies beyond conventional approaches are essential for preventing recurrence.
PATIENT CONCERNS: We report a 37-year-old woman had recurrent low back pain and radiating right lower extremity pain for 2 years, which had exacerbated over the past week. Imaging revealed mild L5 spondylolisthesis, a free fragment of the L5-S1 lumbar disc, bilateral L5 pars defects (spondylolysis), and floating L5 lamina. Treatment involved L5 right laminectomy and L5-S1 lumbar interbody fusion. On postoperative day 6, the patient developed headache and bulging at the incision site.
DIAGNOSES: Combined with analysis of the aspirated fluid, magnetic resonance imaging indications and patient's symptoms, a diagnosis of delayed CSF leak was made.
INTERVENTIONS: Resection of the remaining and floating L5 left lamina and direct suturation were performed for dural tear repair followed by postoperative drainage tube placement.
OUTCOMES: The patient was discharged with successful recovery 2 weeks after the second surgery. Follow-up lumbar magnetic resonance imaging confirmed resolution of the CSF leak and satisfactory recovery.
LESSONS: In lumbar pathologies with unique anatomy like a floating lamina, vigilance for delayed CSF leak is crucial. Meticulous preoperative imaging review and adaptable surgical strategies beyond conventional approaches are essential for preventing recurrence.