Efficacy of a novel drainage catheter in the treatment of CSF leak after posterior spine surgery: A retrospective cohort study

Abstract

Purpose: This work aimed to evaluate and analyze the efficacy and safety of modified drainage and catheterization in the treatment of cerebrospinal fluid leakage (CSFL) after posterior spinal surgery.

Methods: A total of 12 patients with CSFL were selected from June 2020 to June 2023. The modified drainage technique was used to treat CSFL. The perioperative index, including the duration of drainage tube placement, was observed. The study also assessed the amount of cerebrospinal fluid (CSF) drainage, the healing time of the drainage wound, the occurrence of other complications, the effectiveness of the drainage procedure, and the length of hospital stay.

Results: Among the patients with CSFL, the mean drainage time was 6.2 ± 0.8 days, the healing time of the drainage wound was 9.6 ± 1.7 days, and the hospital stay was 7.5 ± 1.0 days. The total volume of CSF drainage was 488.6 ± 55.3 mL. Furthermore, no cases of retrograde infection, drainage orifice exudate, or drainage wound nonunion were reported in this study.

Conclusion: This preliminary study demonstrates that the modified catheterization technique is effective in reducing the duration of CSFL and promoting rapid wound healing. Additionally, the novel drainage catheter shows advantages in terms of reducing the incidence of infection and other related complications.

Keywords: cerebrospinal fluid drainage; cerebrospinal fluid leak; posterior spinal surgery; surgical complications.

Figure 1

(a) Traditional method of drainage puncture and placement of cerebrospinal fluid leaks involves the puncture needle passing straight through the skin, fascia, and muscle, with the drainage tube forming a straight line between the skin, fascia, and muscle layers. (b) Modified drainage puncture and placement technique shows a 45° oblique puncture to the skin to reach the surface of the lumbar dorsal fascia; it then moves 1.5–2 cm longitudinally across the surface of the lumbar dorsal fascia and finally 45° obliquely out of the lumbar dorsal muscle layer. The lumbar muscle layer is then passed diagonally at 45° until it reaches the peri-vertebral plate. This results in a zigzag pattern of drainage tunneling through the subcutaneous, fascial, and muscular layers.

Figure 2

Modified drainage catheter for CSFL during scoliosis surgery. (a) Puncture the needle into the skin and subcutaneous tissue at a 45° angle. (b) The puncture needle was placed 1–2 cm parallel to the surface of the dorsal fascia of the lumbar spine. (c) The needle is inserted into the muscles of the lower back at an angle of 45°, so that the tunnels in the muscles and subcutaneous tissue are arranged in a Z-shape. (d) In the end, the drainage system passes through tunnels in two different levels.