Multilayer fascia lata reconstruction for recurrent ventral cervical cerebrospinal fluid leak following anterior cervical surgery: A technical case report

Background: Dural tear with cerebrospinal fluid (CSF) leakage is an uncommon but potentially serious complication of anterior cervical surgery. Recurrent leakage after failed repair is particularly challenging because the confined anterior corridor may preclude primary dural closure. Case Description: A 71-year-old man developed recurrent CSF leakage after C4–C5 anterior cervical discectomy and fusion despite initial repair with TachoSil ® , Tisseel ® , lumbar drainage, and wound drainage. At revision surgery, the ventral dura was thin and friable and could not retain sutures. A multilayer autologous fascia lata inlay–onlay reconstruction was performed, reinforced with Tisseel ® and crushed local muscle. The repair was watertight on Valsalva testing, and lumbar and subcutaneous drainage were maintained postoperatively. No recurrent CSF leakage, wound breakdown, or pseudomeningocele occurred during 3 months of follow-up. Conclusion: Multilayer fascia lata reconstruction may provide a practical salvage option for recurrent anterior cervical CSF leakage when primary dural suturing is not feasible.