Background: A dreaded complication of spine surgery is Cerebrospinal fluid (CSF) Leak. A CSF leak may result in pain, wound healing complications, infection, meningitis, spinal abscess, increased hospital stay, and/or reoperation. A gold standard of post operative management of CSF leak is still lacking. The authors describe a technique of CSF drainage that may improve the current management of post operative CSF leak without addition hospital stay or reoperation.

Methods: A retrospective case series review of spine surgery cases performed by 2 attending surgeons from the Brain and Spine Institute, Cardinal Santos Medical Center, was performed. In all, 241 charts were reviewed, spanning a 5-year period. There were 18 cases in which CSF leak was detected. All cases of CSF leak were managed by outpatient intermittent percutaneous drainage using a gauge 23 butterfly needle and a 20-cc sterile syringe.Patients were reevaluated at regular intervals for and underwent repeat drainage every 1-4 days dependent on the need and persistence of CSF leak.

Results: All patients observed in this study had CSF leak, All patients were treated using Intermittent percutaneous CSF drainage and none of the patients needed revision surgery to close the CSF leak. The duration of the leak for the all patients were at approximately 20 days on average, with a standard deviation of 15 days. The most common factors noted in the study population were increasing age, number of operative levels, use of the posterior approach, and corticosteroid use.

Conclusion: The use of Outpatient Intermittent percutaneous CSF drainage represents a viable alternative in the treatment of CSF leak as seen in the resolution of signs and symptoms of all 18 patients. On the risk factors for the occurrence of CSF leak, the most noted factors besides increased age were the number of operative levels, use of the posterior approach, and corticosteroid use.