Prevention And Treatment Of Cerebrospinal Fluid Leakage In Spinal Surgery

Objective: To analyze the reasons of cerebrospinal fluid leakage (CSFL) in spinalsurgery, and to investigate the prevention and the treatment measures ofcerebrospinal fluid leakage.Methods: A retrospective analysis was taken of35cases suffered cerebrospinal fluidleakage after spinal surgery from January,2010to January,2014in our department.The suture group in which the nozzle was deeply sutured after extubation consistedof15cases, while the control group in which the nozzle was not deeply sutured afterextubation consisted of20cases. When dural damage or cerebrospinal fluid leakagewas encountered in the surgery, we found out the damaged parts and sutured it directlyif the damaged parts’diameter was less than1/4circumference, while repaired theother with alternative materials when the diameter was greater than1/4circumferenceor compressed it with absorbable gelatin sponges directly when the damaged part washard to suture or to restore. Then negative pressure drainage tube was placed normally,and incision tissue was sutured layer by layer at last. The nozzle was deeply suturedin the suture group after extubation while not in the control group. Patients wereasked to bed rest, adjusting their position. Effect of the intraoperative methodsand postoperative treatments were retrospectively analyzed.Results: In this study, the suture group stopped leakage in6(4，18) days (averagefluid volume:210.03±99.53ml) after surgery, while the control group stoppedleakage in11(5，41) days (average fluid volume:14.00±10.09ml). The compared twogroups was statistically different (p<0.05). We could draw the conclusion that theperiod of group with postoperative deep suture after cerebrospinal fluid leakage wasshorter than the seamless one.The incision infection was found in8cases and wascontrolled well with medcine. Conclusion: Deep suture after extubation in the treatment of cerebrospinal fluidleakage is a good method, which not only can stop the cerebrospinal fluid leakagein a short time, but also can reduce the probability of infection and othercomplications. Most cerebrospinal fluid leakage in spinal surgery can be cured byreasonable conservative treatment.