{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:44:26Z","timestamp":1785426266756,"version":"3.56.0"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"S0317167125104885_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Spinal CSF leaks are a known cause of spontaneous intracranial hypotension, often presenting with orthostatic headaches and other neurological symptoms. While epidural blood patches are commonly used as initial treatment, many patients require surgery due to persistent symptoms. This study integrates a retrospective institutional cohort and a systematic literature review to evaluate the safety and efficacy of surgical dural repair for spontaneous spinal CSF leaks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167125104885_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective chart review included all patients who underwent surgery for spontaneous spinal CSF leak at a Canadian center between June 2017 and December 2023. Clinical presentation, imaging findings, surgical approach and postoperative outcomes were assessed. A PRISMA-compliant systematic review identified studies reporting surgical management and outcomes for spinal CSF leaks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167125104885_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty patients (21 females, 19 males; mean age 50.48 \u00b1 11.88 years) were included. Type 1 ventral dural CSF leaks predominated (72.5%), most commonly in the thoracic spine. Spinal longitudinal extradural collection and cranial stigmata were present in 70% and 75%, respectively. Microscopic direct dural repair led to clinical improvement in 82.5%, with headache resolution or improvement in 85.72%. The complication rate was 7.5% with all complications being transient. The systematic review included 20 studies (483 patients), reporting an 84.06% pooled surgical success rate, with transient complications most common in direct suturing techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167125104885_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Surgical repair is a safe and effective treatment for spontaneous spinal CSF leaks, particularly in patients with failed conservative treatment. Favorable outcomes support early, anatomically guided surgical intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/cjn.2025.10488","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T04:42:07Z","timestamp":1765514527000},"page":"1-9","source":"Crossref","is-referenced-by-count":2,"title":["Direct Surgical Repair of Spontaneous Spinal CSF Leak: A Retrospective Canadian Cohort and Systematic Literature Review"],"prefix":"10.1017","author":[{"given":"Eric M.","family":"Massicotte","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03dbr7087","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Toronto"},{"id":[{"id":"https:\/\/ror.org\/042xt5161","id-type":"ROR","asserted-by":"publisher"}],"name":"University Health Network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Nanna","family":"Lokhamp","sequence":"additional","affiliation":[{"name":"Northern Ontario School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5857-0135","authenticated-orcid":false,"given":"Karlo","family":"Pedro","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03dbr7087","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Toronto"},{"id":[{"id":"https:\/\/ror.org\/042xt5161","id-type":"ROR","asserted-by":"publisher"}],"name":"University Health Network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peyton","family":"Lawrence","sequence":"additional","affiliation":[{"name":"University Hospital of the West Indies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jed","family":"Lazarus","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03dbr7087","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Toronto"},{"id":[{"id":"https:\/\/ror.org\/042xt5161","id-type":"ROR","asserted-by":"publisher"}],"name":"University Health Network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandan","family":"Marathe","sequence":"additional","affiliation":[{"name":"Cardinal Gracias Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Hejrati","sequence":"additional","affiliation":[{"name":"Kantonsspital St. Gallen and Medical School of St. Gallen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3899-7494","authenticated-orcid":false,"given":"Fran\u00e7ois","family":"Dantas","sequence":"additional","affiliation":[{"name":"Biocor Instituto\/Rede D\u2019Or"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Peng","sequence":"additional","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0893-8813","authenticated-orcid":false,"given":"Yasmine","family":"Hoydonckx","sequence":"additional","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Farb","sequence":"additional","affiliation":[{"name":"Toronto Western Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,12,12]]},"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167125104885","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T07:10:44Z","timestamp":1769757044000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167125104885\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":0,"alternative-id":["S0317167125104885"],"URL":"https:\/\/doi.org\/10.1017\/cjn.2025.10488","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]}}}