I had the belly fat , the titanium mesh Ã¢â‚¬Â¦ and later also
had CSF leaks. ???I interviewed 9 surgeons and only one said that he always
does a lumbar drain as a precautionary measure. HEI however did not
think this was necessary and mentioned it can lead to other complications by having another access point to spinal fluid. They said they Ã¢â‚¬Å“ifÃ¢â‚¬? there was a need then later a lumbar can be placed in.
I ended up with inflammation and leaks. WHO KNOWSÃ¢â‚¬Â¦maybe
we should have done a lumbar drain before the surgery- hard to sayÃ¢â‚¬Â¦ However know mine healed on its own, without a shunt, and I never
had an infection. The key is to ask your surgeon what his infection rate is.
RE quoting Lori, Ã¢â‚¬Å“maybe he put some spackle over the mesh?Ã¢â‚¬?
Actually some surgeons do this- it is called Ã¢â‚¬Å“calcium phosphate cement pasteÃ¢â‚¬?. Other surgeons feel that it increases the chance of infection and are very opposed to this. My neurosurgeon did not to do this and consequently I can very much feel my big indentation below the skin.
(BTW my tumor was 4cm)
I brought the Ã¢â‚¬Å“lumbar drainÃ¢â‚¬? and the Ã¢â‚¬Å“spackleÃ¢â‚¬? issue up and got different
answers form each different
surgeon I interviewed.
I know of one person, on this forum, that went with one of the surgeons, I personally interviewed and later crossed off my list
, and he DID seal her with the calcium phosphate cement. I asked him what his infection rate was and he basically indicated it was Ã¢â‚¬Å“almost nil
Ã¢â‚¬?. Later she and I connected and communicated after my surgery. She informed me she actually suffered from meningitis after a shunt was later put in (to deal with CSF leaks) Ã¢â‚¬Â¦and she now complains of cognitive issues. (Does that make her one of the Ã¢â‚¬Å“nillÃ¢â‚¬? stats being that she had her surgery before I interviewed him?!? Our AN world is small and eventually us patients do get to talk to each otherÃ¢â‚¬Â¦ I am wondering how much honest infection rate
reporting took place-in her case.)
I am thinking:
a) that the calcium phosphate may have introduced the bacteria to her CSF
b) she would not have needed a shunt if a lumbar drain was in place
(I am not
a surgeon - so not sure)
c) the cognitive issues are not from an AN but more likely from the meningitis she got as a complication of the CSF leak (I.e. inflammation of the brain)This is a very valid question to ask?
Again-Know that my leaks cleared up on its own without a shunt. Meanwhile as I was experiencing periodic leaks at home- I was taking my temp, ever hour, ready to fly into emergency at the 1st sign of meningitis. It was a stressful and tense time- expspecially since I live out in the country and not in the same state where my surgeon practiced -when this was all happening.
got an infection! (9 Months later I am doing fine- here
Patients also need to be aware that meningitis can also enter in through a lumbar drainÃ¢â‚¬Â¦ but also know that to treat meningitis a lumbar drain is put inÃ¢â‚¬Â¦ to alleviate any inflammation to the brain.
From my experience the lumbar drain is still a much debated issues within the AN medical community (it was right up there with T/L vs R/S for large tumors and facial nerve preservation
Daisy Head Mazy
Some people do not
want to know all
of this information as it is overwhelming
. I was one who wanted to know all
I could- thus I interviewed so many world renown surgeons and specifically asked about the Ã¢â‚¬Å“lumbar drainÃ¢â‚¬? and Ã¢â‚¬Å“the skull spackleÃ¢â‚¬?
Here is more information Ã¢â‚¬Å“IFÃ¢â‚¬? you care to know
calcium phosphate cement Ã¢â‚¬â€œ article that mentions infectionhttp://linkinghub.elsevier.com/retrieve/pii/S0278239104012662
(my understanding is that this is still under research- re infection rate)
Risks with the lumbar drainhttp://uscneurosurgery.com/infonet/surgery/understand/risks/procedure/lumbar%20drain.htm
quote Ã¢â‚¬Å“CONCLUSIONSÃ¢â‚¬â€External lumbar drainage seems to carry a low risk of infectious meningitis and offers a safe alternative to ventriculostomy or serial lumbar punctures. Antibiotics do not seem to protect completely against developing the infection. The infection happens most often with skin organisms. The meningitis often appears within 24 hours after lumbar drain placement. Daily CSF samples should include bacterial cultures but cell counts may not offer any additional useful information in diagnosing the complication. Lumbar drain insertion and management need not be confined to the intensive care unit.Ã¢â‚¬?