ArticleOperative neurosurgery (Hagerstown, Md.)2025
Safety, Sequelae, and Efficacy of Nerve Root Clipping in Patients With Spontaneous Spinal Cerebrospinal Fluid Leaks.
Article in Operative neurosurgery (Hagerstown, Md.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Low interstitial fluid in patients with spontaneous intracranial hypotension.Fluids and barriers of the CNS · 2026Article
- Injecting nerves with radiological contrast as a novel method of studying the peripheral nervous system.Journal of anatomy · 2026Article
- Acute subdural hematoma in spontaneous intracranial hypotension: illustrative case and review of the literature.Brain & spine · 2026Article
- Volumetric response after closure of a spinal CSF leak in patients with spontaneous intracranial hypotension: a multicompartmental longitudinal study.Journal of neurointerventional surgery · 2025Article
- Return to work - estimated socioeconomic impact of spontaneous intracranial hypotension and effects of neurosurgical treatment.Frontiers in neurologyArticle
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Authors and funding
13 authors.
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Abstract
BACKGROUND AND
objectivesSpinal cerebrospinal fluid (CSF) leaks may cause a myriad of clinical symptoms, the most common being orthostatic headache. Lateral leaks (Type II) and direct CSF-venous fistulas (Type III) are a subgroup of spinal CSF leaks, representing about 1/3 of spinal CSF leaks. This study aimed to analyze the risk and efficacy of nerve root clipping in patients with Type II and Type III CSF leaks.
methodsAll consecutive patients with Type II and Type III CSF fistulas treated with nerve root clipping at our institution from May 2018 to December 2022 were included. Patients were evaluated for postoperative sensory motor deficits and neuropathic pain using the "Douleur Neuropathique 4" questionnaire, and the outcome was evaluated using the "Patient Global Impression of Change" and the return-to-work rate.
resultsA total of 40 patients were included, and the mean follow-up time was 22 months. According to the Patient Global Impression of Change, significant symptoms improvement was reported in 85% of patients. Over 87% of patients returned to work fully or partially. One patient experienced a low-grade motor deficit after T1-nerve root clipping. 2.5% of patients developed postoperative neuropathic pain requiring medical treatment under which they fully improved. Over 80% of patients developed dermatomal hypoesthesia, with no reported effect on quality of life.
conclusionThe surgical strategy of noneloquent nerve root clipping shows favorable outcomes and return-to-work rates. There are instances of neuropathic pain and dermatomal hypoesthesia with no significant morbidity. Despite the favorable outcome and low recurrence rate, nerve root-sparing surgical techniques should be further explored.
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