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Case Reports
. 2023 Mar 31:14:116.
doi: 10.25259/SNI_100_2023. eCollection 2023.

Navigated lumbar drain placement: A description of technique and case example

Canada T Montgomery  1 , Rachel Blue  1 , Michael Spadola  1 , Sonia Ajmera  1 , Rashad Jabarkheel  1 , James Schuster  1
Affiliations
Case Reports

Navigated lumbar drain placement: A description of technique and case example

Canada T Montgomery et al. Surg Neurol Int. .

Abstract

Background: Lumbar drain (LD) placement can be a difficult procedure leading to postprocedure complications, particularly in patients with persistent cerebrospinal fluid leaks or a large body habitus. The objective of this technical case report is to describe the use of Medtronic's SureTrak Navigation system for navigated LD placement.

Case description: The patient was an 18-year-old morbidly obese male who initially underwent a suboccipital craniectomy with duraplasty and a C1 laminectomy for Chiari Malformation. Postoperatively, he developed a pseudomeningocele and was taken to the operating room for wound revision, duraplasty repair, and LD placement. Medtronic's SureTrak Navigation system was used for LD placement before wound revision. Successful LD placement was achieved in a single pass using the SureTrak Navigation. The patient did well postoperatively, and LD removal occurred on postoperative day 6. The patient was discharged in good condition without evidence of a cerebral spinal fluid leak.

Conclusion: Navigation using the SureTrak system is a reasonable option to use in patients with a high body mass index and a persistent cerebrospinal fluid leak. When the patient is already undergoing an operative procedure, it can aid in an efficient low-risk intervention completed in a single prone positioning.

Keywords: Cerebrospinal fluid; Cerebrospinal fluid leak; Lumbar drain; Medtronic SureTrak; Navigation; Neurosurgery.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Patient and navigation setup. The patient was placed in the prone position and Ioban was used to secure the navigation reference frame over the thoracic spine.
Figure 2:
Figure 2:
Navigation probe registration. Medtronic SureTrak Navigation system was registered to the Tuohy spinal needle using the navigation probe as depicted for lumbar drain placement.
Figure 3:
Figure 3:
Navigation-guided computerized topography (CT) images. Lumbar CT images illustrate the use of the Medtronic SureTrak Navigation system allowing for successful lumbar drain placement. The left image shows an axial view. The right image shows a sagittal view.
See this image and copyright information in PMC

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