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Lee BJ, Sohn MJ, Han SR, et al. Analysis of risk factors and management of cerebrospinal fluid morbidity in the treatment of spinal dysraphism. J Korean Neurosurg Soc. 2013;54(3):225-31doi: 10.3340/jkns.2013.54.3.225.
Lee, B. J., Sohn, M. J., Han, S. R., Choi, C. Y., Lee, D. J., & Kang, J. H. (2013). Analysis of risk factors and management of cerebrospinal fluid morbidity in the treatment of spinal dysraphism. Journal of Korean Neurosurgical Society, 54(3), 225-31. https://doi.org/10.3340/jkns.2013.54.3.225
Lee, Byung-Jou, et al. "Analysis of risk factors and management of cerebrospinal fluid morbidity in the treatment of spinal dysraphism." Journal of Korean Neurosurgical Society vol. 54,3 (2013): 225-31. doi: https://doi.org/10.3340/jkns.2013.54.3.225
Lee BJ, Sohn MJ, Han SR, Choi CY, Lee DJ, Kang JH. Analysis of risk factors and management of cerebrospinal fluid morbidity in the treatment of spinal dysraphism. J Korean Neurosurg Soc. 2013 Sep;54(3):225-31. doi: 10.3340/jkns.2013.54.3.225. Epub 2013 Sep 30. PMID: 24278652; PMCID: PMC3836930.
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J Korean Neurosurg Soc. 2013 Sep;54(3):225-31. doi: 10.3340/jkns.2013.54.3.225. Epub 2013 Sep 30.

Analysis of risk factors and management of cerebrospinal fluid morbidity in the treatment of spinal dysraphism.

Journal of Korean Neurosurgical Society

Byung-Jou Lee, Moon-Jun Sohn, Seong-Rok Han, Chan-Young Choi, Dong-Joon Lee, Jae Heon Kang

Affiliations

  1. Department of Neurosurgery, Inje University Ilsan Paik Hospital, College of Medicine, Goyang, Korea.

PMID: 24278652 PMCID: PMC3836930 DOI: 10.3340/jkns.2013.54.3.225

Abstract

OBJECTIVE: Spinal dysraphism defects span wide spectrum. Wound dehiscence is a common postoperative complication, and is a challenge in the current management of cerebrospinal fluid (CSF) leaks and wound healing. The purpose of this study is to evaluate the risks of CSF-related morbidity in the surgical treatment of spinal dysraphism.

METHODS: Ten patients with spinal dysraphism were included in this retrospective study. The median age of the cohort was 4.8 months. To assess the risk of CSF morbidity, we measured the skin lesion area and the percentage of the skin lesion area relative to the back surface for each patient. We then analyzed the relationship between morbidity and the measured skin lesion area or related factors.

RESULTS: The overall median skin lesion area was 36.2 cm(2) (n=10). The percentage of the skin lesion area relative to the back surface ranged from 0.6% to 18.1%. During surgical reconstruction, 4 patients required subsequent operations to repair CSF morbidity. The comparison of the mean area of skin lesions between the CSF morbidity group and the non-CSF morbidity group was statistically significant (average volume skin lesion of 64.4±32.5 cm(2) versus 27.7±27.8 cm(2), p<0.05). CSF morbidity tended to occur either when the skin lesion area was up to 44.2 cm(2) or there was preexisting fibrosis before revision with an accompanying broad-based dural defect.

CONCLUSION: Measuring the lesion area, including the skin, dura, and related surgical parameters, offers useful information for predicting wound challenges and selecting appropriate reconstructive surgery methods.

Keywords: CSF morbidity; Lipomyelomeningocele; Meningomyelocele; Spinal dysraphism; Surgical reconstruction; Tethered cord syndrome

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