To investigate the treatment of iatrogenic cerebrospinal fluid (CSF) leak that develops after degenerative lumbar spinal surgery with a subfascial drainage and clipping (SDC) technique. This study retrospectively reviewed the medical records of 46 patients who developed iatrogenic CSF leak after surgery for lumbar degenerative spine disease from 2007 to 2019. Twenty-five patients were treated with the SDC procedure (SDC group), whereas 21 were not (control group). Outcomes were compared between the two groups. CSF leakage ceased within 6-9 days (average 7.4+/-1) after the procedure in the SDC group. In the control group, CSF leakage was controlled with conservative measures in 14 patients, and in 7 patients, lumbar external drainage was performed. Among these 7, the CSF leak was controlled by lumbar external drainage in 3, and 4 required reoperation to repair the dural defect. No infection occurred in either group. Length of hospital stay was also shorter in SDC group (8.4+/-1 vs 10.0+/-1.3 days, p less than 0.001). The SDC technique is effective for the treatment of iatrogenic CSF leak that develops after degenerative lumbar spinal surgery.

Background: Retropharyngeal abscess (RPA) is a life-threatening, dangerous condition and uncommon in adults. The coexistence of RPA, cervical spinal epidural abscess (CSEA), and spondylodiscitis is extremely rare. Case presentation: We present a case with a retropharyngeal and epidural abscess caused by spondylodiscitis. A 61-year-old man was referred to our clinic with the complaints of sore throat, limitation in neck range of motion, numbness, and weakness in the left arm and the left ear for one month. The airway was not obstructed. Neurological deficits were detected in his left arm. Cervical computed tomography revealed a 50 × 30 × 15 mm retropharyngeal abscess. Cervical magnetic resonance imaging showed abscess, C5–6 spondylodiscitis and epidural abscess, and myelopathic signal changes in the C3–7 spinal cord. The abscess was drained, and C5–6 discectomy was performed. The patient was discharged with cervical collar and antibiotics. Conclusions: Multidisciplinary approach that consists of otolaryngologist, neurosurgeon, and infectious disease specialist is needed to avoid complications and any delay.

AIM: To assess the classical and functional imaging features of patients with pathology located in the eloquent areas of the brain who were admitted to our centre between October 2012 and February 2018. We also studied intraoperative somatosensory evoked potential (SEP), motor evoked potentials (MEP), phase reversal, cortical mapping, the extent of resection and the calculation of postoperative morbidity. MATERIAL and METHODS: We compared our results with previous studies in which this technique was not used. The patient records of 163 patients were reviewed retrospectively after approval by the institutional ethics committee and comparisons were made with reports in the literature. RESULTS: The lesion was localised in the visual cortex in eight of the 163 patients. We did not encounter any abnormality in the VEP recordings, so the surgeries were continued. The remaining 155 cases were followed by intraoperative SEP and MEP monitoring. We observed a greater than 50% decrease in the amplitude and an increase in latencies that was greater than 10% in intraoperative MEP and SEP monitoring in 24 patients of 155. Although 8 of 24 patients with abnormal SEP and MEP values were corrected with manuveurs, 6 patients developed increased neurological deficits postoperatively. CONCLUSION: In conclusion, all of these methods should not be seen as competitive with each other; they could be considered as complementary. All of these methods are helpful for a surgical team regarding loss of neurological function. The rate of loss might be up to 100% and irreversible despite corrective maneveurs.