Treatment experience for full-thickness wound dehiscence with cerebrospinal fluid leakage following posterior primary spine surgery: Three case reports

• Published in: Medicine (Baltimore) Vol. 98; no. 15; p. e15126
• Main Authors: Feng, Chen, Qianqian, Shao, Jianhua, Hu, Yu, Zhao, Yipeng, Wang, Jianguo, Zhang, Guixing, Qiu
• Format: Journal Article
• Language: English
• Published: United States the Author(s). Published by Wolters Kluwer Health, Inc 01.04.2019; Wolters Kluwer Health
• Subjects: Cerebrospinal Fluid Leak - etiology; Cerebrospinal Fluid Leak - therapy; Clinical Case Report; Female; Humans; Male; Middle Aged; Spinal Stenosis - surgery; Spine - surgery; Spondylosis - surgery; Surgical Wound Dehiscence - therapy
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000015126

Full-thickness wound dehiscence with cerebrospinal fluid (CSF) leakage following posterior spine surgery is a rare but troublesome complication. In the present study, 3 clinical cases associated with this entity are reported. The first case developed incision effusion 5 days after posterior decompression and internal fixation for lumbar spinal stenosis. The second case has the same diagnosis and treatment with the first case. She developed intraoperative CSF leak and incision effusion 7 days after the surgery. The third case developed incision effusion 6 days after posterior single door laminoplasty for cervical spondylosis. All cases developed CSF leak, incision effusion and finally full-thickness wound dehiscence on the postoperative period. Bed rest, drainage, vacuum sealing drainage (VSD), and reoperations were applied in all of the patients. Trapezius flap transfer was applied to the third case. One lumbar patient developed deep infection and meningitis; thus, the internal fixation and bone graft were removed. All of the patients received wound healing finally and were followed up for >6 months. No incision complications reoccurred, and preoperative symptoms significantly relieved. Several techniques can be adopted to minimize the incidence of complications and proper surgical repair is the most important. Lumbar cistern drainage and VSD are recommended. Some other available options of management will also help.