TREATMENT OF POSTOPERATIVE CEREBROSPINAL FLUID LEAKAGE BY BLOOD PATCH METHOD IN PATIENTS UNDERGOING VERTEBRA SURGERY

Abstract

Objective: One of the complications in patients undergoing vertebra surgery is the prolonged cerebrospinal fluid (CSF) leakege due to incidental dura mater injury. Controlling this drainage is important in orthopedics practice with respect to vertebra surgery. Our aim was to investigate the effectiveness of widely used blood patch in the treatment of prolonged CSF leakage in patients undergoing vertebra surgery. Materials and Methods: In this retrospective study, we reviewed medical records of patients who underwent vertebra surgery in our orthopedics and traumatology department. Among the 1385 patients examined, we included 64 of them who were performed blood patch and had ≥10 days of CSF discharge postoperatively. Results: In 64 of 1385 patients evaluated within the scope of the study, the results of patients who had CSF leakage for 10 days or more and were treated with blood patch were investigated. The distribution of operation site in patients who received blood patch showed that the most commonly involved site was lumbar site due to isolated lumbar surgery (n=32). It was observed that the leakage stopped from the 1st hour dressing in 4 of the patients, from the 6th hour in 27 of them, and from the 24th hour in 22 of them. Leakage in 5 patients stopped between day 1 and day 5. The most common complication of the blood patch application in patients with ≥10 days of CSF leakage was local low-back pain (28.1%, n=18). Conclusion: The blood patch seems to be an effective, practical, cheap, and successful method with low rate of complications for reducing/ stopping prolonged CSF leakege after spine surgery.