OBJECTIVE AND IMPORTANCE:The purpose of this report is to describe the placement and use of a cervical subarachnoid catheter for cerebrospinal fluid diversion. This technique provides an important alternative drainage system for patients whose clinical situations preclude lumbar spinal fluid diversion.CLINICAL PRESENTATION:Two patients were involved in accidents that resulted in traumatic dural tears. Both patients required thoracolumbar spinal reconstruction with instrumentation. Cerebrospinal fistulae developed, which were refractory to surgical reexploration.TECHNIQUE:A commercially available catheter was successfully placed in the cervical subarachnoid space under fluoroscopic guidance using a C1-C2 approach in both patients. Spinal fluid drainage was maintained for 5 days via this route, and this proved effective in resolving the cerebrospinal fluid fistula. No complications were observed with the placement or maintenance of the catheter.CONCLUSION:Cervical spinal fluid drainage is a feasible alternative for patients in whom lumbar access cannot be obtained or is contraindicated.