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Spinal fluid leak after surgery
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tanyaNpain posted:
Hi! I recently had surgery to repair a herniated disc at L5-S1. My doctor sliced open the lining of my spinal cord, resulting in 3 more operations to stop my spinal fluid from leaking out. He told me that it was an "incidental tear" (not his fault, of course) and that it happens all the time - very common, according to him. The leaks have been repaired, thanks to a different surgeon, but I was wondering if anyone else has experienced this? Thanks!!

  • PS - I'm proof that you can't go into back surgery thinking that you'll be relieved of pain afterwards - my pain is no better than it was before Edward Scissorhands cut me up! Make sure you have a spine specialist and have exhausted all other options before back surgery!!!
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    patb1211 responded:
    Hi Tanya, I did not have that happen, but a friend of mine did. Her surgeon (which was also mine) snipped the spinal cord. She had to stay flat for like 48 hrs I think it was . As for the pain after surgery , I was told that the surgery would fix what was wrong but would not take care of the pain. That I would always have pain afterwards. My surgery stabalized my back which was needed badly. I do have pain but it is controlled with my meds. I dont think there is any back surgery that will alieveate the pain we have.
     
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    grampaphil responded:
    Hi Tanya,

    Yes, at that level, they call it the Thecal Sac. The Ortho Spine surgeon called in a neurosurgeon during the surgery and removed a lot of herniation and other stuff that was impinging on the Thecal Sac. The neurosurgeon then stitched the tear. I had to lie flat on my back for 2 1/2 days to be sure there was no leak.

    You are very fortunate that your leak did not cause major problems. I understand all sorts of things can happen including an infection that could find its way to the brain.

    My surgery was necessary not only for pain but because I was losing function. As it is, I remain with a worsened right drop foot which requires me to wear a leg brace to walk. I have pain but it seems to be an off and on thing worsened by too much activity.

    Surgery is definitely a last resort. You are never the same after spine surgery.

    Phil
     
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    shar46 responded:
    First I want to welcome you to the board. I am so sorry that you had this experience. It isn't bad enough just to have back surgery but then when something like that happens makes it even worse than what was expected.

    It did not happen to me thank goodness I was wondering what type of surgeon you had was he a neurosurgeon or an orthopedic surgeon? Not that it should have anything to do with it but neurosurgeons should be so aware of the spinal nerves and cord since that is there specialty. If it wasn't his fault whose was it?? I hate to say this but we have a whole lot of people here that are the same proof about back surgery as you.

    As Pat said her surgeon and mine told me that pain would not be relieved by surgery in my back. It should never be done expect for stabilization or loss of function. Leg pain is usually helped by it though.

    I hope you stick with us. This is a great support board and we can always use someone else's opinions. So either way hopefully we can help each other through our problems. Again welcome.

    Aloha Shar
     
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    nan2159 responded:
    Hi Tanya & WELCOME

    I have been on this board for several years (this is a note to that doctor) I have not had anyone here that I know of, had this happen to them. SO as for as that doctor telling you that it is common, Well no, it is not. I would find a good attorney and take his pratice from him so others do not have to suffer from his shakie hands. What a jerk. Sweetie, I am glad that you found a good doctor to take care of his mistake.

    Most everyone here are because the surgery did not take away the pain. I know my 2 cervical surgeries did not help me as for as I can tell. I am still suffering with pain and numbness. I am also suffering with lower back pain. The doctors are working on that right now because I have told them no surgery for me again.

    Tanya, I am Gald that you found us. We can be here for you. We "DO" understand what you are going through. We may even think of something that a doctor may not.

    Tanya, It was nice meeting you but I am sorry that you had to find us also. If you need to vent, cry or scream, We will be here for you. I also have a good shoulder to lean on too.

    I hope you have a LpD (low pain day)

    Take Care & God Bless,Nan
     
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    tanyaNpain responded:
    You guys are so awesome - thank you for all your support. I'm so glad I found you!!!

    To answer your questions about my doc: He is a general orthopedic surgeon, and he was supposed to be one of the best in town. But hindsight is 20/20..... looking back, there were so many red flags that were screaming at me. But I'm only in my early 30's, and before this mess I'd never had a major illness, never been in a hospital and had never even thought about having surgery for anything. My first visit with this quack should have sent me running. He walked in & I handed him my MRI, which was on a CD. He couldn't figure out how to look at it on his computer; I excused this because I have had a lot of MRI's in the past & most of my doctors preferred written reports or films to CD's. But when I told him the results of the MRI (massive herniation at L5/S1), he said, "So, I'm guessing you want to have surgery?" At this point, I'd been thru a few doctors, PT, and months of severe sciatic pain that was progressing into immobility - and I thought surgery was the only option I had left. He said that I had a 95% chance for successful surgery and pain alleviation, a 1% chance of paralysis or death. I said that I'd never had any surgery before, so if there was anything else I should know about, please tell me.... there was nothing. The visit took 5 minutes - literally - and I left thinking that in a few weeks I would be back to normal. How naive!! I wish I had found you guys so much sooner.

    I've been cut open in the same place 4 times, so my scar is horribly disfiguring. The doc works at a group where they also have 3 spine specialists - wish I'd known that, too. But why didn't he refer me to one of them?? I'm so incredibly frustrated.

    Thanks again for listening. The sciatic pain is still here, so I'm going to start seeing a pain management doc soon.
     
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    Cheryle1955 responded:
    Yes, the same thing happened to me; I had back surgery in 2005 to remove a growth on my spine. When I woke up from the anesthesia the doctor told me that something went wrong when trying to remove the entire growth. She told me she had to perform a complete lumbar laminectomy, the bony projection off the back of the vertebra and the lamina on each side are removed. During this procedure she accidently tore a hole in the lining of my spinal cord and I was leaking spinal fluid. This surgery was only supposed to be 2 hrs and took 6. I was only supposed to be in the hospital for 2 days but because of the tear I had to stay for 6 days. I had to stay flat on my back not being able to sit up or eat the entire time. I was on a liquid diet due to choking hazards. On the 6th day it was very difficult trying to sit up no less trying to walk. I kept fainting due to the fact that I was on my back immobile for so long. Then the recovery it was also difficult but once I recovered I felt great until about 6 months later when I started getting scar tissue on my spinal cord due to the laceration. I was then diagnosed with Arachnoiditis this is a debilitating condition characterized by severe stinging and burning pain and neurologic problems. It is caused by an inflammation of the arachnoid lining surrounding spinal cord. This inflammation causes constant irritation, scarring, and binding of nerve roots and blood vessels. Today I still suffer with severe pain and take pain medication everyday and receive Lumbar Epidural Steroid Injections for Low Back Pain and Sciatica every six months.
     
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    bj1208 responded:
    hi tanya - welcome to the board - sorry you are having so many issues with ur back surgery - it can really suck! LOL

    had back surgery 2/2008 - they told me they could fix the disc problem (removed disc and put plate, cage, screws in) but that they can only guarantee a 50/50 chance on reducing the pains - at which is why i'm here! hehe -

    chronic lower back pains, nerve damage in both legs (have to wear leg brace on left leg) - wear back brace and because of how i sleep and/or sit in bed i have carpel tunnel and wear braces on my wrists! oh well - such is life!

    please do talk to an attorney - i believe you would have a good case for that - take care and keep us informed as to how ur doing - joy
     
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    kiddykop1 responded:
    I had back surgery for a L-5/S-1 herniation to relieve the pressure on my nerves and to clean up the herniation. During the surgery, I had a complication. The neurosurgeon accidentally tore my spinal cord while removing the disk and scar tissue. The doctor told me that it happens all the time. Now, I have had some of the worse headaches I have ever had for a month now. Not ,only does my head hurt, but now I have had a swelling on my back that gets bigger every day and the doctor really does not seem to be too worried about it but I am because it is the size of a soccer ball. I have been told by my doctor that I have air on my brain and may have to go back to the hospital to go to the hospital again for 2 days for oxygen therapy to get the air bubbles off of my brain. It is amazing to me that a person can go through so much, but what I am worried about is can this stuff kill me?
     
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    serendipity888 responded:
    Steffie, If I were you I would go to the emergency room and request that a patch be placed to stop the leak. I feel your surgeon is being very cavalier about your health.

    It is no wonder that you have a headache, but the potential for infection is very concerning to me. I would seek help from the hospital as soon as possible.

    Please let us know how you are.
     
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    achiver21 replied to serendipity888's response:
    Hi Guys, This is a great group exactly what I was looking for. My mom had lower back surgery to relieve her of back pain. Bulging disk compressing on nerves. After Surgery just like what I have read here, Dr cut her spinal by mistake which she was told is common. Now shes back in hospital with complains about headache. After 3rd MRI, they determine another surgery is a must to stop leakage which is causing all the headache and pain again in her lower back. Her pain hasn't changed and we are on mercy off our Neurologist.

    At this point dont know what to do!
     
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    An_189471 responded:
    I had a badly rpuputred C7 and surgery, great outcome, full function restored no problems. Then 90 days later ruputered L5/S1; horrible pain in leg. Had surgery. Great outcome, no pain back to work. Some general post surgery lack of energy but probably went back to work too soon.

    HInts: Get MRI read by some one who does only this, go to nuerosurgeon who does only this. I went to Yale minimally invasine spine group and they do this all the time. My room mate had agony for three years and he walked out of there with me and he is doing great also. Perhaps only people with bad outcomes report on this site. But there are good outcomes as well.

    I suggest, respectfully, when the disk is blown out and sitting on the nerve, get it fixed. Perhaps not the first option, but after conservative therapy has failed and you have been at least 8 to 12 weeks in pain with a clear cut MRI evaluation, go for it.

    Modern micro surgery techniques are amazing and risk reward is worth serious coinsideration.
     
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    DUKE MEDICINE
    Joe T Minchew, MD replied to An_189471's response:
    This is an old post with a recent addition. However, I wanted to respond and try to clarify some issues related to spinal fluid leaks following spinal surgery.

    The reality is that an incidental or unintended puncture of the membrane (dura) that surrounds and contains the spinal cord, nerve rootlets and spinal fluid is a well described complication of any spinal surgery procedure. While it is not common (more than 50%), it is certainly not rare or unheard of. The actual occurence can be varible but published studies vary from a occurrence of 1-2% to as high as 7% in first time surgeries. This will partially depend on the problem that resulted in the spinal surgery. Sometimes in spinal stenosis, the bones and ligaments have become so tight around the dura that a hole has been eroded into the dura even before surgery. Also, the dura becomes thinner and thus more easily punctured with age. The incidence of these dural punctures is higher, sometime 2-3 times higher in revision surgeries because the scar tissue may be stuck to the dura or the dura stuck to the bone. In general, the spinal fluid leak is detected at the time of surgery and can be repaired. This is successful in solving the problem over 90% of the time. However, as some of the members have pointed out, a chronic leak can develop that requires more surgery. While this is a complication of the surgery and not the outcome that either the patient or the doctor would want, it does not constitute a deviation from the standard of care and is not malpractice. It is a known complication of surgery that you should be informed about when you sign a surgical consent.

    Another clarification, while injuries to the nerves or spinal cord can occur during surgery and are also known complications, a tear or puncture of the membrane containing the fluid, the dura is not a tear of the spinal or spinal cord. The cord and nerves are separate structures. Also, the spinal cord actually ends in our lower chest, around the twelth thoracic vertebra. The spinal cord gives off nerve roots at is end that are called the cauda equina (because it looks like a horses tail) so there is not a spinal cord to be torn or injured in the lower back.

    JTM
     
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    marilynk2 responded:
    You have had a rough time to be sure but I want to lighten the picture with a story about what happened to me following a spinal tap for a Lupus test.

    The doc did a get job doing my spinal tap but its my body that wouldn't cooperate afterwards and I blame my bodies slow healing process. I got an waful spinal fluid leak headache and it was a weekend. I couldn'tget the doc on call to pick up. i was a hurtin turkey and with this office, didn't know what to do. monday morning, i called them as soon as they opened as let them know how much i hurt and how unhappy i was I couldn't get help over the weekend. They got me in ASAP. Well, where I had this spinal patch done, a procedure where they made another hole ABOVE where the tap was done and then take 20cc of your blood and let it drip down so it cooagulates and stops the leaking of the fluid. They wheel me into the room where this is to be done, expecting a woman who had had an epidural for her delivery. The nurse asks me when I had my baby, and with a straight face,and I was nervous, I told her "17 years ago, I guess I'm a little slow getting to this!" There was silence and I said I had a spinal tap for a Lupus test on Friday. They finished getting me ready asking me what it all was about. This doc xomes in and explains the procedure and how they will get 20 cc's of blood once he has the needle situated in my back. I then teell him how hard it is to draw blood from me. He decides to not have a nurse do the draw but another doctor and in comes this very short doc. They have to get her a step stool as the other doc is tall so the table is elevated for him. If I wasn't so nervous I would have been laughing. But, as soon as that blood coagulated around the leak, my headache was instantly vanished.

    It was the same orders about being still, just like after the spinal tap. But, it is one procedure I will never forget. My daughter is almost 22 and will graduate college in May!
     
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    TonyaLM71 replied to kiddykop1's response:
    I have been going through issues with my sister for over 5 years now...with her spinal cord accidental "cut" during surgery. At present she is finally being looked at for what the doctor is saying is a "chiari malformation" on her brain. She has a shunt that goes from the area in her back where the "fluid" leaked...this shunt re-routes the fluid to her stomach so her body can digest and dispose of it...I would be very very careful about having headaches...she has been in and out of hospitals I would say easily 25 times over the past 5 years because of severe headaches. Please be checked and be careful!


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