Martin H Pham1, Alexander Tuchman2, Andrew Platt2, Patrick C Hsieh2. 1. Department of Neurosurgery, Keck School of Medicine, LAC+USC Medical Center, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90089, USA. martinpham@gmail.com. 2. Department of Neurosurgery, Keck School of Medicine, LAC+USC Medical Center, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90089, USA.
Abstract
PURPOSE: Though rare, intracranial complications have been reported as a result from spinal surgery. Most if not all of these are a result of intracranial hypotension from durotomy and cerebrospinal fluid (CSF) leak. We aimed to characterize these complications across a large postoperative population at our institution. METHODS: We conducted a retrospective review of all patients who underwent spinal surgery at our institution by four neurosurgeons from July 2008 to August 2013. RESULTS: Our review yielded 1113 consecutive patients who underwent spinal surgery for a total of 1396 procedures. Intracranial imaging using either computed tomography or magnetic resonance imaging was obtained on 59 (4.2%) patients after a procedure due to neurologic change. Six patients (0.4%) were found to have intracranial findings of subdural hygroma (4 patients), remote cerebellar hemorrhage (1 patient), or subdural hematoma (1 patient). CONCLUSION: Intracranial complications from spinal surgery are a rare event. We demonstrate an incidence of 0.4% of total intracranial pathology after spinal surgery. A strong clinical suspicion must be maintained after durotomy or CSF leak due to these infrequent but potentially life-threatening complications.
PURPOSE: Though rare, intracranial complications have been reported as a result from spinal surgery. Most if not all of these are a result of intracranial hypotension from durotomy and cerebrospinal fluid (CSF) leak. We aimed to characterize these complications across a large postoperative population at our institution. METHODS: We conducted a retrospective review of all patients who underwent spinal surgery at our institution by four neurosurgeons from July 2008 to August 2013. RESULTS: Our review yielded 1113 consecutive patients who underwent spinal surgery for a total of 1396 procedures. Intracranial imaging using either computed tomography or magnetic resonance imaging was obtained on 59 (4.2%) patients after a procedure due to neurologic change. Six patients (0.4%) were found to have intracranial findings of subdural hygroma (4 patients), remote cerebellar hemorrhage (1 patient), or subdural hematoma (1 patient). CONCLUSION: Intracranial complications from spinal surgery are a rare event. We demonstrate an incidence of 0.4% of total intracranial pathology after spinal surgery. A strong clinical suspicion must be maintained after durotomy or CSF leak due to these infrequent but potentially life-threatening complications.
Entities:
Keywords:
Complications; Durotomy; Intracranial hypotension; Spinal surgery