Evidence map›Paper›PMID 41963695›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026

Perioperative risk factors predicting CSF leak and retethering following tethered cord release for complex spinal lipomas.

Kelsi M Chesney, Joseph H McAbee, Alan Balu, Jiaqi Liu, Aadit Mehta, Thomas Stirrat, Foad Kazemi, Katherine Daniels, Chima Oluigbo, John S Myseros and 1 more

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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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11 authors.

Kelsi M ChesneyDepartment of Neurosurgery, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA.
Joseph H McAbeeDepartment of Neurosurgery, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA.
Alan BaluGeorgetown Medical School, Washington, DC, USA.
Jiaqi LiuGeorgetown Medical School, Washington, DC, USA.
Aadit MehtaGeorge Washington University Medical School, Washington, DC, USA.
Thomas StirratGeorgetown Medical School, Washington, DC, USA.
Foad KazemiDepartment of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
Katherine DanielsPrinceton University, Princeton, NJ, USA.
Chima OluigboDepartment of Neurosurgery, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA.
John S MyserosDepartment of Neurosurgery, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA.
Robert F KeatingDepartment of Neurosurgery, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA. Rkeating@childrensnational.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTethered cord release (TCR) is typically well tolerated in children, but cerebrospinal fluid (CSF) leaks can occur postoperatively, with rates as high as 33%. The aim of this study was to determine perioperative risk factors associated with CSF leaks and retethering following TCR for complex spinal lipomas to predict higher risk patients.

methodsA retrospective review was performed for complex spinal lipoma patients who underwent TCR at Children's National Hospital from 1996 to 2023. Demographics, operative techniques, postoperative management, and outcomes were analyzed.

resultsA total of 131 patients with complex spinal lipomas underwent 168 operations for TCR. Fifteen patients experienced a postoperative CSF leak (8.9%). Patients with an increased leak risk were significantly older (11.2 vs. 1.2 years), presented symptomatically, and had a history of prior detethering. A significantly higher number of leaks was observed after dural closure with Nurolon sutures compared to Prolene. Lying flat postoperatively for fewer days did not influence leak rates. Leak patients experience significantly longer hospital stays, higher wound infection rates, and a higher likelihood of retethering. Patients with preoperative symptoms, prior TCR, and transitional lipomas had a lower PFS and were more likely to retether after TCR.

conclusionChildren undergoing TCR for complex spinal lipomas may be at higher risk of CSF leak if they are older, underwent prior detethering, or presented symptomatically. Nurolon sutures may increase leak risk compared with Prolene. Interestingly, lying flat for fewer days postoperatively did not increase leak risk, suggesting patients may be able to safely mobilize sooner.

Indexed as

Cerebrospinal Fluid LeakLipomaNeural Tube DefectsNeurosurgical ProceduresPostoperative ComplicationsSpinal Cord NeoplasmsAdolescentChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesRisk FactorsCerebrospinal fluid leakLipomaLipomyelomeningoceleSpinal dysraphism

Identifiers

PMID41963695

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