• D Yoshor, J B Gentry, S A LeMaire, J Dickerson, J Saul, A B Valadka, and C S Robertson.
• Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA. dyoshor@tmh.tmc.edu
• J. Neurosurg. 2001 Apr 1; 94 (2 Suppl): 319-22.

AbstractThe authors describe the case of a 24-year-old man who underwent an L-1 corpectomy for spinal decompression and stabilization following an injury that caused an L-1 burst fracture. Postoperatively, an accumulation of spinal fluid developed in the pleural space, which was refractory to 1 week of thoracostomy tube drainage and lumbar cerebrospinal fluid (CSF) diversion. The authors then initiated a regimen of positive-pressure ventilation in which a bi-level positive airway pressure (PAP) mask was used. After 5 days, the CSF collection in the pleural space resolved. Use of a bi-level PAP mask represents a safe, noninvasive method of reducing the negative intrathoracic pressure that promotes CSF leakage into the pleural cavity and may be a useful adjunct in the treatment of subarachnoid-pleural fistula.

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