Spontaneous postoperative cerebrospinal fluid leaks following application of anti-adhesion barrier gel - Case report and review of the literature

Study Design. This report documents cerebrospinal fluid leakage after application of anti-adhesion barrier gel in a single-surgeon clinical series of 27 patients treated with ADCON-L(R) (Gliatech, Cleveland, OH) during surgery. Objective. To discuss a heretofore unreported postoperative complication when using an anti-adhesion barrier gel for lumbar spinal surgery. Summary of Background Data. Anti-adhesion barrier gel has been touted as a beneficial adjunct to lumbar surgery. No previous report has been identified that documents the complication encountered in this series. Methods: During the time that ADCON-L(R) was used, in a 9-month period, all spinal surgeries were reviewed, end those cases where ADCON-L(R) was used were documented. The reports of all surgeries then were reviewed for complications during surgery, and clinical follow-up information was obtained. Results. Five of 27 cases receiving ADCON-L(R) during surgery developed cerebrospinal fluid leakage. Three of these patients required reoperation. Conclusion. The excessive rate of cerebrospinal fluid leakage after the use of ADCON-L(R) is significant, and the morbidity associated with its use outweighs the potential benefit of the product.