胸椎黄韧带骨化症手术并发硬脊膜损伤或脑脊液漏的原因分析及防治

Causes and prevention of spinal dural injury or cerebrospinal fluid leakage in thoracic ossification of ligamentum flavum

目的研究胸椎黄韧带骨化症手术并发硬脊膜损伤或脑脊液漏的原因及防治方法。方法选择2010年1月~2016年1月医院收治的胸椎黄韧带骨化症手术并发硬脊膜损伤或脑脊液漏的患者30例,对其临床资料进行回顾性分析,总结此类并发症的发生原因,并对相应的防治方法进行探讨。结果胸椎黄韧带骨化症手术并发硬脊膜损伤或脑脊液漏的主要原因包括骨化黄韧带与硬脊膜严重粘连(63.33%),硬脊膜骨化与骨化黄韧带融合(20.00%),术中器械损伤硬脊膜(10.00%),术中操作损伤根神经(6.67%)等。结论胸椎黄韧带骨化症手术并发硬脊膜损伤或脑脊液漏的原因较为复杂,在临床防治当中,主要采取以俯卧位为主的综合治疗方法。

Objective To study the causes and prevention of spinal dural injury or cerebrospinal fluid leakage in thoracic ossification of ligamentum flavum.Methods From January 2010 to January 2016 Hospital of ossification of the ligamentum flavum surgery complicated with dural injury or cerebrospinal fluid leakage in 30 patients,the clinical data were retrospectively analyzed,summarized the causes of these complications,and the corresponding control methods are discussed.Results The main causes of dural injury or cerebrospinal fluid leakage in patients with ossification of thoracic ligamentum flavum include severe adhesion(63.33%) of ossification of ligamentum flavum and dura mater(63.33%),ossification of dura mater and ossification of ligamentum flavum(20.00%),hard spinal membrane(10.00%) during operation,and injury of root nerve(6.67%) during operation.Conclusion The causes of dural injury or cerebrospinal fluid leakage in thoracic ossification of ligamentum flavum are complicated.In the clinical prevention and treatment,the treatment of prone position is the main treatment.