Subarachnoid--pleural fistulae--management with a transdiaphragmatic pedicled greater omental flap: report of two cases

Abstract

Study design: This report describes the treatment of chronic subarachnoid--pleural fistulae using a pedicled greater omentum transfer flap.

Objective: To describe a new technique for the management of chronic subarachnoid--pleural fistulae resulting from thoracic dural tears.

Summary of background data: Thoracic dural tears with leakage of cerebral spinal fluid into the pleural space can occur after thoracic spine surgery. The treatment of chronic subarachnoid--pleural fistulae using an omental flap, however, has not been reported.

Methods: The clinical, radiographic, and surgical details of two cases are described.

Results: Pedicled greater omentum transferred to the thoracic spine was an effective method in the treatment of intractable thoracic dural tears for two patients.

Conclusion: These cases demonstrate that pedicled greater omentum transferred to the thoracic spine can be a safe and effective technique for the management of intractable thoracic dural tears and their complications.