Management Of Dural Injuries And Postoperative Cerebrospinal Fluid Leakage In Spinal Surgeries

Objective:To investigate the cause and efficacy of treatment of dural injuries and postoperative cerebrospinal fluid leakage(CSFL) in spine surgery. Methods:A total of 3020 cases performed spine surgery were analyed retrospectively form january 2004 to october 2008 in oure division.Include 197 males,110 females, the average of patients was 50.1 years.65 (2.15%)patients occured cerebrospinal fluid leakage of 307 cases(10.2%) those had intraoperative dural injury or incision and 10 of them were not found the dural injured. To analysis the cause and efficacy of cerebrospinal fluid leakage in spinal surgery and to investigate its treat-ment. Result:Cerebrospinal fluid leakage was found elicited by spinal dura opening in 197cases(64.1%) of iatrogenic agent. The 307 patients had been treatment that 205 cases obtained cure course apply bioprotein gel and gelatin sponge after suturation, other patients had cured by autologous tissue and gelatin sponge etc. But cerebrospinal fluid leakage still existed after operation in 65 cases,59 of them were cured by limit body position, pressure dressing wounds etc. And the other 6 occured infection that had been cured by antibiotic which can pass through the blood-brain barrier, incision and irrigate etc. Conclusion:Iatrogenic injury is an important cause inducing cerebrospinal fluid leakage in spinal surgery. Cerebrospinal fluid leakage can be cured by suture or repair of the dura and postoperative conservative treatment. Cerebrospinal fluid leakage concurrent infection should be discover and treat in time.