腰椎术后迟发脑脊液漏的预防和治疗

目的探讨腰椎术后迟发脑脊液漏的预防和治疗。方法通过回顾性的方法对1999年1月至2012年7月所发生的26例腰椎术后迟发脑脊液漏患者的临床资料进行分析总结,其中男19例,女7例;年龄25~70岁,平均32.8岁。结果经过卧床休息、延长拔管时间和伤口加压包扎等综合治疗1~3周后,所有患者的脑脊液漏症状治愈。经过平均3.3年的随访,术后未发现脑脊液漏,无硬脊膜假性囊肿形成和腰痛、头痛等症状。结论通过术前充分的准备,术中仔细操作并及时对硬膜损伤进行有效修补,术后采取正规的保守治疗,可以降低腰椎术后迟发脑脊液漏的发生。

Prevention and Treatment of Later Cerebrospinal Fluid Leakage in Lumbar Surgery

Objective To explore the prevention and treatment of later cerebrospinal fluid leakage in lumbar surgery. Methods A retrospective analysis was performed on the clinical data of 26 patients who suffered from later cerebrospinal fluid leakage in lumbar surgery between January 1999 and July 2012. Results All the cases were cured between 1 and 3 weeks by conservative treatments including rest in the prostrate position,drainage,compression dressing and so on. The average follow up lasted for 3 year and 3 months,no cerebrospinal fluid leakage cyst formation,lumbago or headache was found. Conclusion The rate of later cerebrospinal fluid leakage in lumbar surgery can be decreased by detailed preoperative preparation,strict operation with effective dural repair and proper treatment postoperation.