Fascia lata packing and tension suturing for symptomatic pseudomeningocele after recurrent cervical intradural tumour resection

Abstract In recurrent posterior cervical intradural tumour resections, serious complications can be developed. The dural can become affected by inflammatory factors or removed during tumor resection; if cerebrospinal fluid (CSF) leakage cannot be stopped by duraplasty, artificial meninges or fascia...

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Autores principales:	Huanbo Xu, Yangliang Huang, Yi Zhong, Guowang Lu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9593b98257bd4cfc92d8498a7d3635de
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spelling	oai:doaj.org-article:9593b98257bd4cfc92d8498a7d3635de2021-12-02T15:52:59ZFascia lata packing and tension suturing for symptomatic pseudomeningocele after recurrent cervical intradural tumour resection10.1038/s41598-021-84193-x2045-2322https://doaj.org/article/9593b98257bd4cfc92d8498a7d3635de2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84193-xhttps://doaj.org/toc/2045-2322Abstract In recurrent posterior cervical intradural tumour resections, serious complications can be developed. The dural can become affected by inflammatory factors or removed during tumor resection; if cerebrospinal fluid (CSF) leakage cannot be stopped by duraplasty, artificial meninges or fascia repair, large pseudomeningocele can develop posteriorly within the soft tissue of the neck. When the pressure of the CSF cannot be maintained steadily, persistent clinical symptoms can occur, such as postural headache or central fever. Moreover, the skin can also be penetrated in a few patients even after extension of the drainage duration, lumbar cistern drainage or skin suturing, leading to the induction of life-threatening intra-cranial infections. Is there a simple and effective surgical method to address this scenario? The aim of this study was, therefore, to investigate the effectiveness of fascia lata packing and tension suturing in the treatment of symptomatic pseudomeningocele after recurrent posterior cervical intradural tumour resection. In our study, nine consecutive spinal surgery patients were recruited from January 2008 to January 2018. All pseudomeningoceles were combined with postural headache, central neurological fever or wound non-union. There were 3 cases of melanocytoma, 3 cases of nasopharyngeal carcinoma metastasis, 2 cases of breast cancer metastasis, and 1 case of spinal canal lymphadenoma. Standard patient demographics, diagnosis, post-operative symptoms, wound healing time, and the largest pre- and last follow-up pseudomeningocele area on axial MRI sections were recorded. All cases were followed-up successfully, from 12 to 24 months, with an average of 15.3 months. Our observations indicate that all wounds healed successfully. The wound union time was 20.7 days on average. After wound union, these patients became symptom free. The largest cerebrospinal fluid area on axial MRI sections improved significantly from 42.9 ± 5.01 cm2 at p re-operation to 6.6 ± 1.89 cm2 at 1 year post-operation (P < 0.05); Our data indicate that .the proposed procedure is simple, safe and effective. And more importantly, it allows rapid closure of any cerebrospinal fluid leakage pools.Huanbo XuYangliang HuangYi ZhongGuowang LuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Huanbo Xu Yangliang Huang Yi Zhong Guowang Lu Fascia lata packing and tension suturing for symptomatic pseudomeningocele after recurrent cervical intradural tumour resection
description	Abstract In recurrent posterior cervical intradural tumour resections, serious complications can be developed. The dural can become affected by inflammatory factors or removed during tumor resection; if cerebrospinal fluid (CSF) leakage cannot be stopped by duraplasty, artificial meninges or fascia repair, large pseudomeningocele can develop posteriorly within the soft tissue of the neck. When the pressure of the CSF cannot be maintained steadily, persistent clinical symptoms can occur, such as postural headache or central fever. Moreover, the skin can also be penetrated in a few patients even after extension of the drainage duration, lumbar cistern drainage or skin suturing, leading to the induction of life-threatening intra-cranial infections. Is there a simple and effective surgical method to address this scenario? The aim of this study was, therefore, to investigate the effectiveness of fascia lata packing and tension suturing in the treatment of symptomatic pseudomeningocele after recurrent posterior cervical intradural tumour resection. In our study, nine consecutive spinal surgery patients were recruited from January 2008 to January 2018. All pseudomeningoceles were combined with postural headache, central neurological fever or wound non-union. There were 3 cases of melanocytoma, 3 cases of nasopharyngeal carcinoma metastasis, 2 cases of breast cancer metastasis, and 1 case of spinal canal lymphadenoma. Standard patient demographics, diagnosis, post-operative symptoms, wound healing time, and the largest pre- and last follow-up pseudomeningocele area on axial MRI sections were recorded. All cases were followed-up successfully, from 12 to 24 months, with an average of 15.3 months. Our observations indicate that all wounds healed successfully. The wound union time was 20.7 days on average. After wound union, these patients became symptom free. The largest cerebrospinal fluid area on axial MRI sections improved significantly from 42.9 ± 5.01 cm2 at p re-operation to 6.6 ± 1.89 cm2 at 1 year post-operation (P < 0.05); Our data indicate that .the proposed procedure is simple, safe and effective. And more importantly, it allows rapid closure of any cerebrospinal fluid leakage pools.
format	article
author	Huanbo Xu Yangliang Huang Yi Zhong Guowang Lu
author_facet	Huanbo Xu Yangliang Huang Yi Zhong Guowang Lu
author_sort	Huanbo Xu
title	Fascia lata packing and tension suturing for symptomatic pseudomeningocele after recurrent cervical intradural tumour resection
title_short	Fascia lata packing and tension suturing for symptomatic pseudomeningocele after recurrent cervical intradural tumour resection
title_full	Fascia lata packing and tension suturing for symptomatic pseudomeningocele after recurrent cervical intradural tumour resection
title_fullStr	Fascia lata packing and tension suturing for symptomatic pseudomeningocele after recurrent cervical intradural tumour resection
title_full_unstemmed	Fascia lata packing and tension suturing for symptomatic pseudomeningocele after recurrent cervical intradural tumour resection
title_sort	fascia lata packing and tension suturing for symptomatic pseudomeningocele after recurrent cervical intradural tumour resection
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9593b98257bd4cfc92d8498a7d3635de
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Fascia lata packing and tension suturing for symptomatic pseudomeningocele after recurrent cervical intradural tumour resection

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