Wirksamkeit und Sicherheit der Lumbaldrainage bei verschiedenen Indikationen: Eine retrospektive Studie mit 477 Fällen

To assess the efficacy and safety of lumbar drainage (LD) across different clinical indications, with a focus on complications.

We retrospectively analyzed 477 patients who underwent LD placement between 2012 and 2022. Indications for LD included perioperative management during aortic surgery (159 cases, 33.3%), postoperative cerebrospinal fluid (CSF) leaks (139 cases, 29.1%), therapeutic CSF drainage (95 cases, 19.9%), postoperative or perioperative relief (76 cases, 15.9%), diagnostic lumbar drainage for normal pressure hydrocephalus (NPH) (3 cases, 0.6%), and other rare indications (5 cases, 1.0%). Complications and patient outcomes were evaluated.

Of the 477 cases, 433 (90.8%) had no complications. However, 24 cases required re-insertion due to insufficient CSF flow. Two patients (0.4%) developed infections, and one patient (0.2%) on acetylsalicylic acid (ASA) suffered an epidural hematoma resulting in paraparesis. Overdrainage occurred in 17 patients (3.6%), manifesting as headaches in 13 cases, headaches with nausea in 4 cases, and subdural hygroma in one case.

Lumbar drainage is a highly effective and safe procedure for various clinical indications. Despite a low overall complication rate, careful monitoring and prompt management of complications, particularly in anticoagulated patients, are essential to optimize outcomes. These findings support the continued use of LD in neurosurgical and perioperative care, while highlighting the need for standardized protocols to mitigate risks.