Cervical intrathecal catheter placement for cerebrospinal fluid drainage: Technical case report

OBJECTIVE AND IMPORTANCE: The purpose of this report is to describe the pla cement 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 divers ion. CLINICAL PRESENTATION: Two patients were involved in accidents that resulte d in traumatic dural tears. Both patients required thoracolumbar spinal rec onstruction with instrumentation. Cerebrospinal fistulae developed, which w ere refractory to surgical reexploration. TECHNIQUE: A commercially available catheter was successfully placed in the cervical subarachnoid space under fluoroscopic guidance using a C1-C2 appr oach 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 o f the catheter. CONCLUSION: Cervical spinal fluid drainage is a feasible alternative for pa tients in whom lumbar access cannot be obtained or is contraindicated.