The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques · 2025
Direct Surgical Repair of Spontaneous Spinal CSF Leak: A Retrospective Canadian Cohort and Systematic Literature Review.
СтатьяНазвание 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.
Massicotte Eric M, Lokhamp Laura Nanna, Pedro Karlo, Lawrence Peyton, Lazarus Jed, Marathe Nandan, Hejrati Nader, Dantas François, Peng Philip, Hoydonckx Yasmine, Farb Richard
Аннотация
BACKGROUND: Spinal CSF leaks are a known cause of spontaneous intracranial hypotension, often presenting with orthostatic headaches and other neurological symptoms. While epidural blood patches are commonly used as initial treatment, many patients require surgery due to persistent symptoms. This study integrates a retrospective institutional cohort and a systematic literature review to evaluate the safety and efficacy of surgical dural repair for spontaneous spinal CSF leaks.
METHODS: A retrospective chart review included all patients who underwent surgery for spontaneous spinal CSF leak at a Canadian center between June 2017 and December 2023. Clinical presentation, imaging findings, surgical approach and postoperative outcomes were assessed. A PRISMA-compliant systematic review identified studies reporting surgical management and outcomes for spinal CSF leaks.
RESULTS: Forty patients (21 females, 19 males; mean age 50.48 ± 11.88 years) were included. Type 1 ventral dural CSF leaks predominated (72.5%), most commonly in the thoracic spine. Spinal longitudinal extradural collection and cranial stigmata were present in 70% and 75%, respectively. Microscopic direct dural repair led to clinical improvement in 82.5%, with headache resolution or improvement in 85.72%. The complication rate was 7.5% with all complications being transient. The systematic review included 20 studies (483 patients), reporting an 84.06% pooled surgical success rate, with transient complications most common in direct suturing techniques.
CONCLUSION: Surgical repair is a safe and effective treatment for spontaneous spinal CSF leaks, particularly in patients with failed conservative treatment. Favorable outcomes support early, anatomically guided surgical intervention.
METHODS: A retrospective chart review included all patients who underwent surgery for spontaneous spinal CSF leak at a Canadian center between June 2017 and December 2023. Clinical presentation, imaging findings, surgical approach and postoperative outcomes were assessed. A PRISMA-compliant systematic review identified studies reporting surgical management and outcomes for spinal CSF leaks.
RESULTS: Forty patients (21 females, 19 males; mean age 50.48 ± 11.88 years) were included. Type 1 ventral dural CSF leaks predominated (72.5%), most commonly in the thoracic spine. Spinal longitudinal extradural collection and cranial stigmata were present in 70% and 75%, respectively. Microscopic direct dural repair led to clinical improvement in 82.5%, with headache resolution or improvement in 85.72%. The complication rate was 7.5% with all complications being transient. The systematic review included 20 studies (483 patients), reporting an 84.06% pooled surgical success rate, with transient complications most common in direct suturing techniques.
CONCLUSION: Surgical repair is a safe and effective treatment for spontaneous spinal CSF leaks, particularly in patients with failed conservative treatment. Favorable outcomes support early, anatomically guided surgical intervention.