Subarachnoid–Pleural Fistulae—Management With a Transdiaphragmatic Pedicled Greater Omental Flap: Report of Two Cases

Abstract

STUDY DESIGN: This report describes the treatment of chronic subarachnoid--pleural fistulae using a pedicled greater omentum transfer flap. OBJECTIVE: To describe a new technique for the management of chronic subarachnoid--pleural fistulae resulting from thoracic dural tears. SUMMARY OF BACKGROUND DATA: Thoracic dural tears with leakage of cerebral spinal fluid into the pleural space can occur after thoracic spine surgery. The treatment of chronic subarachnoid--pleural fistulae using an omental flap, however, has not been reported. METHODS: The clinical, radiographic, and surgical details of two cases are described. RESULTS: Pedicled greater omentum transferred to the thoracic spine was an effective method in the treatment of intractable thoracic dural tears for two patients. CONCLUSION: These cases demonstrate that pedicled greater omentum transferred to the thoracic spine can be a safe and effective technique for the management of intractable thoracic dural tears and their complications.