Management of anterior durotomy in cervical spine

Abstract

The prevalence of cerebrospinal fluid (CSF) leakage in elective anterior cervical spine surgery ranges from 0.3% to 21.4% [1, 2]. The prevalence is significantly higher in patients with ossification of the posterior longitudinal ligament (OPLL) than in those with other degenerative diseases such as cervical spondylotic myelopathy (CSM). In our institute, the prevalence of CSF leakage associated with anterior cervical spine surgery from 1997 to 2014 was 47 of 251 OPLL cases (18.8%) and 3 of 590 CSM cases (0.5%), showing a remarkable difference between these pathologies. Awareness of appropriate management of intra- and postoperative CSF leakage is necessary for cervical OPLL. The aim of this chapter is to describe appropriate management of CSF leakage during anterior surgery for cervical OPLL (Table 76.1).