Back to Search
Start Over
Safety of epidural triamcinolone acetonide use during lumbar decompression surgery in pediatric patients: an association with delayed pseudomeningocele formation
- Source :
- Journal of Neurosurgery: Pediatrics. 17:667-671
- Publication Year :
- 2016
- Publisher :
- Journal of Neurosurgery Publishing Group (JNSPG), 2016.
-
Abstract
- OBJECTIVE The complication profile of epidural triamcinolone acetonide use during lumbar decompression surgery is not known. However, isolated reports of increased risk of delayed CSF leakage with the use of triamcinolone acetonide in adult spinal surgery patients have been published. The purpose of this study was to determine the safety of epidural triamcinolone acetonide use in conjunction with lumbar decompression surgery in pediatric patients. METHODS The medical records of all patients who underwent lumbar decompression surgery with or without discectomy between July 1, 2007, and July 31, 2015, were retrospectively reviewed. RESULTS During the study period, 58 patients underwent 59 spine procedures at Texas Children's Hospital. There were 33 female and 25 male patients. The mean age at surgery was 16.5 years (range 12–24 years). Patients were followed for an average of 38.2 months (range 4–97 months). Triamcinolone acetonide was used in 28 (of 35 total) cases of discectomy; there were no cases of delayed symptomatic CSF leaks (0%) in the minimally invasive and open discectomies. On the other hand, triamcinolone acetonide was used in 14 (of 24 total) cases of multilevel laminectomy, among which there were 10 delayed CSF leaks (71.4%) requiring treatment. The use of triamcinolone acetonide in patients who underwent multilevel laminectomy was significantly associated with an increased risk of delayed CSF leaks or pseudomeningoceles (Fisher's exact test, p < 0.001). CONCLUSIONS There was an unacceptable incidence of delayed postoperative CSF leaks when epidural triamcinolone acetonide was used in patients who underwent multilevel laminectomy.
- Subjects :
- Epidural Space
Male
medicine.medical_specialty
Triamcinolone acetonide
Adolescent
medicine.medical_treatment
Anti-Inflammatory Agents
Triamcinolone Acetonide
Spinal Cord Diseases
Young Adult
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Lumbar
Discectomy
medicine
Humans
030212 general & internal medicine
Child
Retrospective Studies
Cerebrospinal Fluid Leak
Cerebrospinal fluid leak
business.industry
Laminectomy
General Medicine
Decompression, Surgical
medicine.disease
Epidural space
Surgery
Pseudomeningocele
medicine.anatomical_structure
Anesthesia
Female
Complication
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 19330715 and 19330707
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Journal of Neurosurgery: Pediatrics
- Accession number :
- edsair.doi.dedup.....45b0a62302ee21fc33a8935d2568799a