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Leaking Spinal Fluid
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Leaking Spinal Fluid

My sister-in-law had a fusion of L1 and L2 a couple of months ago and is now leaking spinal fluid.  She says she has lost 190 cc's of spinal fluid and is deeply concerned.  She sees an orthopedic doctor, and he told her to lie flat, not to move, and he will go back in a "patch it up" in a few weeks.  She is very concerned and nervous and wants to know how many cc's of spinal fluid can she afford to lose.  Would you consider this surgery an emergency?  I told her I would ask to be switched to a neurosurgeon, and to call and see if she can get it repaired immediately.  Any thoughts or advice you can give would be greatly appreciated.

On an unrelated matter, I personally have a syrinx on my spinal cord from C4-6.  Can you tell me if these symptoms could be related?  When I have flare ups, I get shortness of breath, night sweats, leg weakness, occasional leg pain (left side only) severe neck and occipital pain and headaches.  Sometimes I have difficulty urinating -- it's like my bladder is asleep and it takes a while for it to work.  This happens sometimes due to too much activity, sometimes due to nothing.  My dr. says he doesn't think shunting it will help at this point, and for now we are going to monitor the size with MRI's.  Will this ultimately progress?  It is due to trauma and not Chiari Malformation.  Any thoughts you can give me would be appreciated.  Thanks for this wonderful site.  It has been most helpful.
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Avatar_n_tn
We make about 25cc of CSF every hour, so the amount lost in the last 2 months should theoretically have taken 8hrs to make up. However, this does not mean it's ok to have a post-op spinal leak as it can be a cause of severe positional headaches. It's a common complication of back surgery from a tear in the tissue (dura) covering the area the spinal cord passes through. It's often easily corrected (depending on the cause) with surgical intervention, but not something we sit on for a "few weeks." Your sister should talk to the orthopedist again and let them know how concerned she is. If they are not willing to take any action, i agree with your thought about a second opinion with a neurosurgeon. But she should be prepared to get all her films and op notes to show them as they were not there for the initial surgery.

Symptoms don't sound like they're coming from the cervical region as this would usually manifest in weakness/sensory changes of the arms. It's possible that it will progress. But I agree with your doc that observation for now with serial MRIs and clinical signs/symptoms would be the way to go as you are not experiencing any direct symptoms from it and surgery doesn't always help. Good luck.
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A related discussion, leakin spinaal fluid was started.
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A related discussion, How do you know when a CSF Leak has healed? was started.
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