腰椎手术并发症-脑脊液漏的研究进展

李全; 张源; 梁跃伟; 阮锐; 赵学凌; 谢世伟; 张霖

腰椎手术并发症-脑脊液漏的研究进展

昆明医科大学第一附属医院骨科

基金项目:

基金：国家自然科学基金资助项目 (81560366); 云南省内设机构科研基金资助项目 (2016NS021);

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出版历程
- 收稿日期: 2017-04-03

Research Progress of Cerebrospinal Fluid Leakage in Lumbar Spine Surgery

Funds:

基金：国家自然科学基金资助项目 (81560366); 云南省内设机构科研基金资助项目 (2016NS021);

摘要

摘要: 脑脊液漏 (CSF) 是腰椎手术常见的并发症.过去10 a中, 在理解脑脊液漏的基础上, 腰椎术后脑脊液漏的护理和治疗技术取得重大的进步.回顾以前腰椎手术术中或术后导致脑脊液漏的不同因素及治疗技术的相关文献, 提出可供选择的护理和治疗方法及各种技术, 并重点强调目前的治疗趋势.讨论介绍了脑脊液漏的发生因素, 基本概念和实践治疗方法.腰椎术后脑脊液漏的各种管理技术以及不同预后在本文中做了很好的陈述.然而, 目前并没有最理想的治疗技术可供选择, 在每一种具体情况下, 每种治疗技术的选择依赖于每个外科医生的经验, 对患者病情的认识, 脑脊液漏的性质和部位, 以及依赖现有的设施和设备.
- 腰椎手术 /
- 并发症 /
- 脑脊液漏 /
- 硬脊膜撕裂
Abstract: Cerebrospinal fluid leakage (CSF) is a common complication of lumbar spine surgery.Over the past decades, there has been significant advancement in understanding the basis, management and techniques of treatment for post-operative CSF leak following lumbar spine surgery.In this article, we review previous lumbar surgery or after surgery in literatures related to different factors and treatment of cerebrospinal fluid leakage, for selection of care and treatment methods and technology are presented and emphasis on the current treatment trends.This article also discusses the factors that cause the leakage of cerebrospinal fluid, the basic concepts and methods of practice.Cerebrospinal fluid leakage after operation of various management techniques and different prognosis in this paper made a good statement.However, there is no ideal treatment options available, in each case, the choice of every kind of treatment technology depends on each surgeon's experience, understanding of each patient's condition, nature and the location of cerebrospinal fluid leakage and relys on the existing facilities and equipment.
- Lumbar surgery /
- Complications /
- Cerebrospinal fluid leakage /
- Dural tear

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参考文献(27)

[1]	[1]PATEL M R, LOUIE W, RACHLIN J.Postoperative cerebrospinal fluid leaks of the lumbosacral spine:management with percutaneous fibrin glue[J].American Journal of Neuroradiology, 1996, 17 (3) :495-500.
[2]	[2]HANNALLAH D, LEE J, KHAN M, et al.Cerebrospinal fluid leaks following cervical spine surgery[J].J Bone Joint Surg Am, 2008, 90 (5) :1101-1105.
[3]	[3]MINSHALL M E, JALLO J, ERNST F R.The potential cost impact of using a PEG hydrogel sealant compared with Fibrin sealant to prevent cerebral spinal fluid leaks after spinal surgery[J].Spine Journal, 2010, 10 (9) :S108-S109.
[4]	[4]WONG A P, SHIH P, SMITH T R, et al.Comparison of symptomatic cerebral spinal fluid leak between patients undergoing minimally invasive versus open lumbar foraminotomy, discectomy, or laminectomy[J].World Neurosurg, 2014, 81 (3/4) :634-640.
[5]	[5]WANG J C, BOHLMAN H H, RIEW K D.Dural tears secondary to operations on the lumbar spine.Management and results after a two-year-minimum follow-up of eighty-eight patients[J].J Bone Joint Surg Am, 1998, 80 (12) :1728-1732.
[6]	[6]RUBAN D, O'TOOLE J E.Management of incidental durotomy in minimally invasive spine surgery[J].Neurosurgical focus, 2011, 31 (4) :E15.
[7]孟阳, 沈彬, 张琰, 等.腰椎后路减压融合术并发脑脊液漏的多因素分析[J].中国脊柱脊髓杂志, 2013, 23 (4) :330-334.
[8]	[8]GUERIN P, EL FEGOUN A B, OBEID I, et al.Incidental durotomy during spine surgery:incidence, management and complications.A retrospective review[J].Injury, 2012, 43 (4) :397-401.
[9]	[9]SMITH J S, OGDEN A T, SHAFIZADEH S, et al.Clinical outcomes after microendoscopic discectomy for recurrent lumbar disc herniation[J].Journal of Spinal Disorders&Techniques, 2010, 23 (1) :30-34.
[10]	[10]TURGUT M, AKY Z O.Symptomatic tension pneumocephalus:An unusual post-operative complication of posterior spinal surgery[J].Journal of Clinical Neuroscience, 2007, 14 (7) :666-668.
[11]	[11]OHRY A, ZEILIG G.Traumatic spinal cord injury followed by cerebrospinal fluid complications[J].Spinal Cord, 1990, 28 (3) :208-211.
[12]	[12]BOSACCO S J, GARDNER M J, GUILLE J T.Evaluation and treatment of dural tears in lumbar spine surgery:a review[J].Clinical Orthopaedics and Related Research, 2001, 389 (389) :238-247.
[13]顾秀婷, 王苇, 袁保锋, 等.磁共振水成像在自发性低颅压中的应用[J].医学影像学杂志, 2015, 10 (2) :1735-1738.
[14]	[14]HUGHES S A, OZGUR B M, GERMAN M, et al.Prolonged Jackson-Pratt drainage in the management of lumbar cerebrospinal fluid leaks[J].Surgical Neurology, 2006, 65 (4) :410-414.
[15]蒋新祥, 路晓, 周金军, 等.腰椎手术后脑脊液漏的处理对策及治疗体会[J].中国骨与关节损伤杂志, 2015, 30 (11) :1197-1198.
[16]	[16]PATEL M R, CARUSO P A, YOUSUF N, et al.CT-guided percutaneous fibrin glue therapy of cerebrospinal fluid leaks in the spine after surgery[J].American journal of Roentgenology, 2000, 175 (2) :443-446.
[17]	[17]MIHLON F, KRANZ P G, GAFTON A R, et al.Computed tomography guided epidural patching of postoperative cerebrospinal fluid leaks:Clinical article[J].Journal of Neurosurgery:Spine, 2014, 21 (5) :805-810.
[18]	[18]KITCHEL S H, EISMONT F J, GREEN B A.Management of post operative CSF leak by closed subarachnoid draining[C]//XIVth Annual Scientific Meeting of Asia.1998.
[19]张振玖, 卢逢文, 唐志敏.持续椎管引流治疗腰椎术后脑脊液漏[J].临床医学工程, 2012, 19 (9) :1519-1520.
[20]马丽亚·玛那普, 孙晶晶.脊柱术后脑脊液漏的护理[J].临床医药文献电子杂志, 2016, 3 (5) :918-919.
[21]徐海栋.数字技术在脊柱微创外科中的应用进展[J].医学研究生学报, 2014, 27 (2) :207-210.
[22]	[22]TOSUN B, ILBAY K, KIM M S M, et al.Management of persistent cerebrospinal fluid leakage following thoraco-lumbar surgery[J].Asian Spine Journal, 2012, 6 (3) :157-162.
[23]	[23]MASSICOTTE E M, GEORGE K J.Chronic Cerebro-Spinal Fluid (CSF) leak[J].Argo Spine News&Journal, 2012, 24 (3-4) :166-172.
[24]王再德, 董明岩, 曹阳, 等.脊柱手术并发脑脊液漏的治疗[J].辽宁医学院学报, 2012, 33 (4) :306-308.
[25]贺爱军.脊柱手术后脑脊液漏的治疗[J].当代医学, 2015, 19 (5) :113-116.
[26]	[26]GHOBRIAL G M, ANDERSON P A, CHITALE R, et al.Simulated spinal cerebrospinal fluid leak repair:an educational model with didactic and technical components[J].Neurosurgery, 2013, 73 (4) :S111-S115.
[27]	[27]MASUDA S, FUJIBAYASHI S, OTSUKI B, et al.The dural repair using the combination of polyglycolic acid mesh and fibrin glue and postoperative management in spine surgery[J].Journal of Orthopaedic Science, 2016, 21 (5) :586-590.

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