Percutaneous treatment of subarachnoid-pleural fistula with Onyx.

Details

Serval ID
serval:BIB_1AA0F90A8851
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Title
Percutaneous treatment of subarachnoid-pleural fistula with Onyx.
Journal
Journal of neurosurgery. Spine
Author(s)
Knafo S., Parker F., Herbrecht A., Court C., Saliou G.
ISSN
1547-5646 (Electronic)
ISSN-L
1547-5646
Publication state
Published
Issued date
04/2013
Peer-reviewed
Oui
Volume
18
Number
4
Pages
378-381
Language
english
Notes
Knafo, Steven
Parker, Fabrice
Herbrecht, Anne
Court, Charles
Saliou, Guillaume
eng
Case Reports
2013/02/26 06:00
J Neurosurg Spine. 2013 Apr;18(4):378-81. doi: 10.3171/2013.1.SPINE12628. Epub 2013 Feb 22.
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
Subarachnoid-pleural fistula is a well-described complication after anterior surgery for thoracic disc herniation, but is difficult to treat by means of traditional chest and lumbar drains due to interference by positive ventilation pressures that may keep the fistula open and prevent proper closure. Current treatment strategies include surgical repair, which is technically challenging, and noninvasive positive pressure ventilation, which can take several weeks to be effective. In this report, the authors describe a novel treatment for subarachnoid-pleural fistula using percutaneous obliteration with Onyx. Surgery for removal of a T7-8 disc herniation associated with ossification of the posterior longitudinal ligament was performed in a 56-year-old woman via an anterior transthoracic transpleural approach. Ten days after surgery, she presented with diplopia due to a subarachnoid-pleural fistula that was confirmed by CT myelography. Percutaneous injection of Onyx was performed under local anesthesia. Postprocedure CT showed complete obliteration of the fistula with no adverse events. A CT scan obtained 1 month later showed complete resolution of the pleural effusion. Neurological examination at 3 months postsurgery was normal. Clinical and radiological follow-up at 1 year showed complete recovery and no sign of fistula recurrence. Percutaneous treatment for subarachnoid-pleural fistula is an easy, safe, and effective strategy and can therefore be proposed as a first-line option for this challenging complication.

Keywords
Dimethyl Sulfoxide/administration & dosage, Dimethyl Sulfoxide/therapeutic use, Embolization, Therapeutic/instrumentation, Embolization, Therapeutic/methods, Female, Fistula/drug therapy, Fistula/etiology, Humans, Middle Aged, Pleural Diseases/drug therapy, Pleural Diseases/etiology, Polyvinyls/administration & dosage, Polyvinyls/therapeutic use, Subarachnoid Space/drug effects, Subarachnoid Space/pathology, Thoracic Vertebrae/pathology, Thoracic Vertebrae/surgery, Treatment Outcome
Pubmed
Create date
20/01/2017 15:30
Last modification date
20/08/2019 12:51
Usage data