Fluid Supplementation Therapy for Cerebrospinal Fluid Leakage Secondary to Thoracic Spinal Decompression Surgery—A Prospective Cohort Study

Study DesignProspective cohort study.ObjectivePostoperative cerebrospinal fluid leakage (CSFL) is a common complication following thoracic spinal stenosis (TSS) surgery. This study aimed to evaluate the therapeutic effects of different fluid supplementation strategies on intracranial hypotension symptoms (IHS) caused by CSFL.MethodsPatients who developed CSFL after TSS surgery at a single center over a 3-year period were prospectively enrolled. All patients received standardized postural and drainage management. In addition, they were administered either low-sodium or high-sodium solution supplementation alongside standard medications. The incidence and severity of IHS and changes of blood electrolyte levels were compared between the two groups.ResultsThe incidence of IHS in low-sodium group is 57.5%, and in high-sodium group is 40% (<i>P</i> = .117). Although, there was no statistically significant difference in the improvement of IHS between the two fluid supplementation strategies. However, statistical differences in blood electrolyte levels were observed. On postoperative days 2 and 3, serum sodium levels were significantly lower in the low-sodium group (139.9 ± 2.08 vs 141.1 ± 3.1, <i>P</i> = .022; 140.0 ± 3.0 vs 141.25 ± 3.85, <i>P</i> = .034).ConclusionWhile high-sodium fluid supplementation tended to reduce the incidence of IHS following CSFL, the difference compared to low-sodium fluids was not statistically significant. Nonetheless, the observed differences in electrolyte level of sodium suggest a potential physiological impact. Further studies with larger sample sizes are needed to confirm these findings.