Pump-regulated lumbar subarachnoid drainage

Paul J. Houle, John R Vender, Kostas Fountas, Dennis E. McDonnell, James R. Fick, Joe Sam Robinson

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

OBJECTIVE: The diversion of cerebrospinal fluid (CSF) has been widely used in the prevention and treatment of CSF fistulae. A common method is the use of a lumbar drainage system. Although it is effective, several serious complications can develop, which can be avoided by regulating the flow of CSF with a standard intravenous infusion pump. TECHNIQUE: We present a simple, inexpensive, and accurate method of flow-controlled lumbar subarachnoid drainage that minimizes patient discomfort and the unpredictability of a gravity-dependent system. This system uses a standard lumbar drain connected to an intravenous infusion pump to provide drainage of CSF in a constant and predictable manner. RESULTS: A total of 42 patients from two institutions were treated with this method. CSF fistulae occurred secondary to trauma in 9 patients, after spinal surgery in 11 patients, after transsphenoidal surgery in 10 patients, and after cranial base surgery in 12 patients. Resolution of the fistula was attained in 36 of 42 patients. There were no deaths, no cases of deep venous thrombosis, and no incidence of meningitis. One patient developed tension pneumocephalus, and two patients developed headache with nausea and vomiting. All patients were ambulatory, and only three patients required narcotic analgesia for headaches. CONCLUSION: Pump-regulated lumbar subarachnoid drainage is safe and effective in the treatment of CSF fistulae, as reported elsewhere in the literature. The advantage of this method is that the drainage of CSF can be carefully controlled and titrated in a predictable fashion. Because the system is independent of gravity to produce drainage of CSF, patients are not confined to bed and serious complications of overdrainage can be avoided.

Original languageEnglish (US)
Pages (from-to)929-932
Number of pages4
JournalNeurosurgery
Volume46
Issue number4
StatePublished - Apr 1 2000

Fingerprint

Drainage
Cerebrospinal Fluid
Fistula
Infusion Pumps
Gravitation
Intravenous Infusions
Headache
Pneumocephalus
Narcotics
Skull Base
Meningitis
Venous Thrombosis
Analgesia
Nausea
Vomiting
Incidence
Therapeutics

Keywords

  • Cerebrospinal fluid fistula
  • Lumbar drainage

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Houle, P. J., Vender, J. R., Fountas, K., McDonnell, D. E., Fick, J. R., & Robinson, J. S. (2000). Pump-regulated lumbar subarachnoid drainage. Neurosurgery, 46(4), 929-932.

Pump-regulated lumbar subarachnoid drainage. / Houle, Paul J.; Vender, John R; Fountas, Kostas; McDonnell, Dennis E.; Fick, James R.; Robinson, Joe Sam.

In: Neurosurgery, Vol. 46, No. 4, 01.04.2000, p. 929-932.

Research output: Contribution to journalArticle

Houle, PJ, Vender, JR, Fountas, K, McDonnell, DE, Fick, JR & Robinson, JS 2000, 'Pump-regulated lumbar subarachnoid drainage', Neurosurgery, vol. 46, no. 4, pp. 929-932.
Houle PJ, Vender JR, Fountas K, McDonnell DE, Fick JR, Robinson JS. Pump-regulated lumbar subarachnoid drainage. Neurosurgery. 2000 Apr 1;46(4):929-932.
Houle, Paul J. ; Vender, John R ; Fountas, Kostas ; McDonnell, Dennis E. ; Fick, James R. ; Robinson, Joe Sam. / Pump-regulated lumbar subarachnoid drainage. In: Neurosurgery. 2000 ; Vol. 46, No. 4. pp. 929-932.
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