[The prevention and treatment of cerebrospinal fluid leakage following cervical spine surgery].

Zhongguo gu shang = China journal of orthopaedics and traumatology(2010)

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Abstract
OBJECTIVE:To investigate curative effect of the prevention and treatment in cerebrospinal fluid leakage (CFL) after cervical surgery. METHODS:Medical records of 607 patients who underwent cervical surgery at our hospital from Feb. 2004 to Feb. 2008 were retrospectively reviewed. Six patients complicated by CFL after surgery were enrolled, of which 4 males and 2 females, age for 47-75 years with an average of 60 years. Course of disease was from 6 months to 5 years. 4 cases occurred at 1-3 days after operation and 2 cases at 5 days. 2 cases were treated through latero-incision drainage, 2 cases continuous subarachnoid drainage, and 2 cases pressure dressing. Clinical outcomes of surgical management were recorded. RESULTS:CFL of all the cases was stopped within 1-3 days after operation,and subarachnoid drainage lasted 10-14 days with an average volume of 320 ml. Three cases had headache, nausea and vomiting; 1 case suffered from somnolence and hyponatremia, and symptoms subsided after treatment. All patients were followed up with an average of 30 months. No cerebrospinal fluid cyst or wound infection were found. There was no significant effects on neuromuscular function recovery. CONCLUSION:Timely and correct surgical intervention and postoperative management have good results for CFL. If it is severe, latero-incision drainage and continuous subarachnoid drainage should be adopted.
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Key words
subdural,cerebrospinal fluid effusion,postoperative complications,cervical vertebrae
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