颈椎后路手术迟发脑脊液漏的预防和治疗

Prevention and treatment of later cerebrospinal fluid leakage in posterior approach cervical surgery

目的探讨颈椎后路手术迟发脑脊液漏的临床疗效。方法通过回顾2000—01—2012-10所发生的7例颈椎后路手术迟发脑脊液漏的临床资料进行分析。结果术后随访4～48个月（平均20个月），未发现脑脊液漏，无脑脊液囊肿形成。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，可以降低颈椎后路手术迟发脑脊液漏的发生。

Objectlve To explore the prevention and treatment of later cerebrospinal fluid leakage in posterior approach cervical surgery. Methods A retrospective analysis was performed on the clinical data of 7 patients who suffered from later eerebrospinal fluid leakage in posterior approach cervical surgery from January 2000 to October 2012. Results Through careful treatment peri-operation,all cases were cured by conservative treatments including bed rest in the prostrate position,catheter drainage,compression dressing and so on. All patients were followed up for 4-48 months （average 20 mouths）. No cerebrospinal fluid cyst and infection oc- curred. There were no significant negative effects of cerebrospinal fluid leakage on the recovery of neuromuscu- lar function. Conclusion The incidence rate of later cerebrospinal fluid leakage in posterior approach cervical surgery can be decreased by detailed preoperative preparation,strict operation with effective dural repair and proper treatment postoperation.