Risk Factors and Clinical Outcomes of Cerebrospinal Fluid Leakage Following Spinal Surgery: Insights from a Single-Center Study

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Abstract
BackgroundCerebrospinal fluid (CSF) leak is a known complication of spine surgery, and an effective protocol for prevention, recognition, and treatment of postoperative CSF leak is essential to avoid a cascade of associated adverse outcomes, such as durocutaneous fistula, wound infection, and intracranial hemorrhage. We aim to identify the incidence of CSF leak post spinal surgeries and to obtain the factors that could predict the risks of having a CSF leak following spine surgeries. MethodsThis study was conducted as a retrospective cohort study on patients who had CSF leaks post spinal surgery in King Abdul-Aziz Medical City, Jeddah, from June 2016 to January 2024. ResultsThe occurrence of cerebrospinal fluid (CSF) leak post-surgery was relatively low (2.6%), and more than 97% of the participants studied had no CSF leak. There is a statistically insignificant relation with age, gender, DM, BMI, hypertension, malignancy, and cardiovascular diseases. Still, there is a statistically significant relation with the attempt to watertight closure, and type of surgery (P value ≤ 0.05). ConclusionPostoperative CSF leak following spinal surgery is associated with morbidity and can lead to re-operation and infection. The incidence of CSF leaks among our study participants was about 2.6%, which is relatively low. Identifying predictors for CSF leaks can assist in counseling patients concerning surgical risk and expected postoperative recovery.

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