Spontaneous postoperative cerebrospinal fluid leaks following application of anti-adhesion barrier gel: case report and review of the literature.

STUDY
DESIGN: This report documents cerebrospinal fluid leakage after application of anti-adhesion barrier gel in a single-surgeon clinical series of 27 patients treated with ADCON-L (Gliatech, Cleveland, OH) during surgery.
OBJECTIVE: To discuss a heretofore unreported postoperative complication when using an anti-adhesion barrier gel for lumbar spinal surgery. SUMMARY OF BACKGROUND DATA: Anti-adhesion barrier gel has been touted as a beneficial adjunct to lumbar surgery. No previous report has been identified that documents the complication encountered in this series.
METHODS: During the time that ADCON-L was used, in a 9-month period, all spinal surgeries were reviewed, and those cases where ADCON-L was used were documented. The reports of all surgeries then were reviewed for complications during surgery, and clinical follow-up information was obtained.
RESULTS: Five of 27 cases receiving ADCON-L during surgery developed cerebrospinal fluid leakage. Three of these patients required reoperation.
CONCLUSION: The excessive rate of cerebrospinal fluid leakage after the use of ADCON-L is significant, and the morbidity associated with its use outweighs the potential benefit of the product.