November 05, 2015
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Irradiation cited as risk factor for cerebrospinal fluid leakage after total en bloc spondylectomy

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Careful consideration of postoperative cerebrospinal fluid leakage should be given to patients with a history of surgical site irradiation who undergo total en bloc spondylectomy, according to the findings in a recently published study.

Researchers analyzed the risk of postoperative cerebrospinal fluid (CSF) leakage after total en bloc spondylectomy and analyzed potential factors for this complication. The study included 72 patients who underwent total en block spondylectomy.

Postoperative CSF leakage was observed in 17 patients (23.6%). Researchers noted the following factors were associated with postoperative CSF leakage: patient age 54 years or older, resection of three or more vertebral bodies, dural injury and preoperative surgical site irradiation. However, after a multivariate analysis, researchers found preoperative surgical site irradiation was the only statistically significant risk factor for the complication.

Overall, 13 patients with postoperative CSF leakage recovered on their own and the remaining four patients required reoperation. All of the patients requiring reoperation had a history of surgical site irradiation.

Researchers concluded surgeons must keep preoperative site irradiation in mind when performing this surgery, as treatment for CSF leakage can be time-consuming and difficult. – by Robert Linnehan

Disclosures: The researchers report no relevant financial disclosures.