Preventing cerebrospinal fluid leak following transection of a tight filum terminale.
J Neurosurg Pediatr
; 8(1): 35-8, 2011 Jul.
Article
em En
| MEDLINE
| ID: mdl-21721886
ABSTRACT
OBJECT Tethered cord release for a tight filum terminale is a common pediatric operation associated with low morbidity and mortality rates. While almost all would agree that keeping patients lying flat after the operation will prevent a CSF leak, the optimal period of doing so has not been determined. In this study, the authors examined whether a longer length of stay in the hospital for the sole purpose of maintaining patients flat correlates with a decreased rate of CSF leakage. METHODS:
Intraoperative and postoperative data were retrospectively collected in 222 cases of simple tethered cord release at 3 large children's hospitals. Risk factors for postoperative CSF leakage were identified.RESULTS:
Thirty-eight patients were maintained lying flat for 24 hours, 86 for 48 hours, and 98 for 72 hours at the individual surgeon's discretion. A CSF leak occurred in 13 patients (5.9%) and pseudomeningocele developed in 9 patients (4.1%). In the univariate analysis, operating time, use of the microscope, use of dural sealant, and duration of remaining flat after surgery failed to correlate with the occurrence of complications.CONCLUSIONS:
A longer hospital stay for maintaining patients flat after a simple tethered cord release appears not to prevent CSF leakage. However, a larger patient cohort will be needed to detect small differences in complication rates.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Repouso em Cama
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Cauda Equina
/
Decúbito Dorsal
/
Doenças do Sistema Nervoso Periférico
/
Tempo de Internação
/
Defeitos do Tubo Neural
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
J Neurosurg Pediatr
Assunto da revista:
NEUROCIRURGIA
/
PEDIATRIA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos