Management of CSF Leaks After Elective Spine Surgery: Routine Laminectomy Leads to Fatal Discitis and Sepsis Jose A Castillo Jr, MD, Richard Price, MD, PhD, Kee D Kim, MD | December 18, 2024

https://psnet.ahrq.gov/web-mm/management-csf-leaks-after-elective-spine-surgery-routine-laminectomy-leads-fatal-discitis Management of CSF Leaks After Elective Spine Surgery: Routine Laminectomy Leads to Fatal Discitis and Sepsis In this WebM&M Spotlight Case with CE/MOC, an older man underwent L4-5 decompressive lumbar laminectomy and discectomy, which was complicated by intraoperative durotomy. At a follow-up visit, he reported clear drainage from the surgical site and the surgeon suspected a cerebrospinal fluid (CSF) leak. Despite conservative management at home, his condition worsened over several weeks before being readmitted with discitis, osteomyelitis and sepsis, resulting in his death 50 days after the operation. The commentary provides an overview of the clinical manifestations of intraoperative durotomy, intra- and post-operative management strategies to address intraoperative durotomy and CSF leaks, and approaches to ensuring patient safety during spine surgery.