Incidence of Post-Operative Cerebrospinal Fluid Leak in Patients Operated for Spinal Dysraphism

Abstract

for spinal dysraphism. Materials and Methods: 80 patients who underwent surgery for spinal dysraphism were enrolled in this study. This study was conducted at Neurosurgery Unit, JPMC, Karachi. Patients from 1 month to 3 years of age were included in the study. Patients were followed for 2 months post-surgery. The incidence of cerebrospinal fluid leak among patients operated for spina bifida was determined. Results: Mean age was 1.5 years ± 5 months. There were 68.7% males and 31.3% females. 47.5% of patients had myelomeningocele, 41.3% of patients had meningocele, and 11.25% of patients had Tethered cords. Among 80 patients, 16.3% developed CSF leaks. 6.3% of patients were those who developed postoperative hydrocephalus and their CSF leak resolved after the VP shunt. In 8.8% of patients, CSF leaks resolved after suturing the leak area. 1.3% of patients with CSF leak developed meningitis; he was kept on antibiotics and was discharged on the 10th day of readmission. 5% of patients developed wound infections, they were kept on antibiotics, and daily dressings and were discharged within a week. Conclusion: Most common location for myelomeningocele and meningocele is the lumbosacral area followed by the thoracic and cervical regions. Overall, 28.6% developed complications. 16.3% of patients developed CSF leaks.CSF leak was seen more in myelomeningocele repair patients as compared to meningocele and tethered cord. Most of the leaks can be managed with simple suturing and VP shunts in patients complicated by postoperative hydrocephalus. Keywords: Myelomeningocele (MMC), Meningocele, Cerebrospinal fluid leak (CSF), VP Shunt.