Subarachnoid-pleural fistula in a pediatric patient following spinal fusion

Subarachnoid-pleural fistulas are a rare but serious complication following either surgery or trauma to the spine or thorax. We present a case of a 3-year old girl who presented with a massive pleural effusion 3 months after spinal surgery. She was diagnosed with a subarachnoid-pleural fistula with the use of pleural fluid analysis for β2-transferrin and CT myelography. She required surgical repair but new evidence suggests there may be less invasive treatment options.