脊柱手术并发脑脊液漏26例病因分析及防治策略

目的探讨脊柱手术并发脑脊液漏的病因及防治策略。方法对2003～2011年笔者在本院所行胸腰椎前后路手术并发脑脊液漏26例,采用直接缝合、筋膜覆盖、使用可吸收明胶海绵、严密缝合切口各层组织、头低臀高位和切口加压包扎。结果 26例均痊愈出院,无一例发生脑脊液感染,无继发深部感染、脑脊液囊肿及马尾神经疝。结论对于脊柱手术并发硬脊膜损伤者,根据损伤程度不同给予相应的修复,恰当处理可有效治疗脑脊液漏。

Etiology analysis of spinal surgery combined with cerebrospinal leak in 26 cases and its preventive strategy

Objective To discuss the etiology and preventive strategy of spinal surgery combined with cerebrospinal leak.Methods Twenty six cases of patients underwent thoracolumbar vertebra anterior and posterior surgical treatments combined with cerebrospinal leak in our hospital from 2003 to 2011 were selected.Direct suture,fascia cover and absorbable collagen sponge were adopted,incision each layer of tissue were sutured strictly,then head-low and feet-high position and incision compression bandage were adopted.Results Twenty-six cases were all cured,there was no case suffered with cerebrospinal fluid inflammation,secondary deep infection,cerebrospinal fluid cyst and horsetail neural hernia out.Conclusion According to different extent of damage to give corresponding repair can treat cerebrospinal fluid leakage effectively in spinal surgery combined with endorhachis damage.