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  • Title: Cervical intrathecal catheter placement for cerebrospinal fluid drainage: technical case report.
    Author: Wahlig JB, Welch WC, Kang JD, Jungreis CA.
    Journal: Neurosurgery; 1999 Feb; 44(2):419-21. PubMed ID: 9932901.
    Abstract:
    OBJECTIVE AND IMPORTANCE: The purpose of this report is to describe the placement and use of a cervical subarachnoid catheter for cerebrospinal fluid diversion. This technique provides an important alternative drainage system for patients whose clinical situations preclude lumbar spinal fluid diversion. CLINICAL PRESENTATION: Two patients were involved in accidents that resulted in traumatic dural tears. Both patients required thoracolumbar spinal reconstruction with instrumentation. Cerebrospinal fistulae developed, which were refractory to surgical reexploration. TECHNIQUE: A commercially available catheter was successfully placed in the cervical subarachnoid space under fluoroscopic guidance using a C1-C2 approach in both patients. Spinal fluid drainage was maintained for 5 days via this route, and this proved effective in resolving the cerebrospinal fluid fistula. No complications were observed with the placement or maintenance of the catheter. CONCLUSION: Cervical spinal fluid drainage is a feasible alternative for patients in whom lumbar access cannot be obtained or is contraindicated.
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