Yu Z, Zhang HFZ, Wang YJ. Surgical treatment of mixed cervical spondylosis with spontaneous cerebrospinal fluid leakage: A case report. World J Clin Cases 2023; 11(29): 7242-7247 [PMID: 37946769 DOI: 10.12998/wjcc.v11.i29.7242]
Corresponding Author of This Article
Yan-Jun Wang, BMed, Director, Doctor, Department of Emergency, Honghui Hospital, Xi’an Jiaotong University, No. 28 Xianning West Road, Xi’an 710032, Shaanxi Province, China. wangyanjun0215@126.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2023; 11(29): 7242-7247 Published online Oct 16, 2023. doi: 10.12998/wjcc.v11.i29.7242
Surgical treatment of mixed cervical spondylosis with spontaneous cerebrospinal fluid leakage: A case report
Zhong Yu, Hao-Fu-Zi Zhang, Yan-Jun Wang
Zhong Yu, Yan-Jun Wang, Department of Emergency, Honghui Hospital, Xi’an Jiaotong University, Xi’an 710032, Shaanxi Province, China
Hao-Fu-Zi Zhang, Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
Author contributions: Yu Z and Zhang HFZ contributed equally to this work; Yu Z, Zhang HFZ and Wang YJ designed research; Yu Z performed research; Yu Z and Zhang HFZ analyzed data; Zhang HFZ and Yu Z wrote the paper.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Jun Wang, BMed, Director, Doctor, Department of Emergency, Honghui Hospital, Xi’an Jiaotong University, No. 28 Xianning West Road, Xi’an 710032, Shaanxi Province, China. wangyanjun0215@126.com
Received: August 19, 2023 Peer-review started: August 19, 2023 First decision: September 4, 2023 Revised: September 7, 2023 Accepted: September 18, 2023 Article in press: September 18, 2023 Published online: October 16, 2023
Abstract
BACKGROUND
Spontaneous cerebrospinal fluid (CSF) leaks associated with cervical spondylosis are rare. To our knowledge, only a few cases have been reported in which treatment is challenging and varies from case to case. Here, we review the literature and describe the surgical treatment of a 70-year-old woman who presented with a CSF leak due to a cervical spine spur.
CASE SUMMARY
A 70-year-old female patient who was treated for a cerebral infarction, presented with complains of weakness in the right lower extremity and a feeling of stepping on cotton. The patient underwent regular neck massage and presented with neck and right shoulder pain radiating to the right upper extremity one-month ago. Magnetic resonance imaging showed a strip of leaking cerebrospinal fluid posterior to the C1-4 vertebrae, and computed tomography showed a “sickle-shaped” disc prolapse with calcification in C4/5. We chose to perform an anterior cervical discectomy. When the prolapsed C4/5 disc was scraped, clear fluid leakage was observed, and exploration revealed a 1 mm diameter rupture in the anterior aspect of the dura mater, which was compressed continuously with cotton patties, with no significant cerebrospinal fluid leakage after 1 h.
CONCLUSION
Three months after surgery, the patient was asymptomatic and follow-up imaging demonstrated complete resolution.
Core Tip: We report a 70-year-old female patient who had been treated for cerebral infarction. She complained of weakness in the right lower extremity and a feeling of stepping on cotton. Magnetic resonance imaging showed a strip of leaking cerebrospinal fluid posterior to the C1-4 vertebrae, and computed tomography showed a "sickle-shaped" disc prolapse with calcification in C4/5. We chose to perform an anterior cervical discectomy. When the prolapsed C4/5 disc was scraped, clear fluid leakage was seen and exploration revealed a 1 mm diameter rupture in the anterior aspect of the dura mater, with no significant cerebrospinal fluid leakage after 1 h.
