Prolonged Drainage to Treat Cerebrospinal Fluid Leakage after Posterior Spinal Surgery

Abstract：Objective To evaluate the effect of prolonged drainage in remedying cerebrospinal fluid leakage after spinal surgery with posterior approach. Methods We retrospective analyzed 2 137 patients consecutively treated with posterior ap-proach in spinal surgery between Jan 2009 and Mar 2012. In which there were 157 patients with dura mater injury following with cerebrospinal fluid leakage and there was cerebrospinal fluid leakage after operation in 68 patients treating with prolonged drainage. The drainage tubes were extracted 5 to 7 days after surgery. According to the part and extent of spinal dura mater in-jury during operation,it could divided into five forms dural tear( DT). DT-1 showed injury in exposed side of dura mater. In DT-2,lesion located at non-exposed side. In DT-3,lesion existed at exposed and non-exposed side. In DT-4,the spinal dura mater whad deficiency. In DT-5,recessive spinal dura mater injury implied dura mater lesion did not found during operation but cerebrospinal fluid leak could be seen. Treatment methods included non-invasive suture directly,suture and pasted with Ear-brain glue( EC glue)or biological fibrin glue( BFG),repaired with gelatin sponge and pasted with EC glue or BFG,renovated with autogenous fat grafts and gelatin sponge and pasted with EC glue or BFG. Results There were 106 cases in DT-1,18 in DT-2,25 in DT-3,1 in DT-4,7 in DT-5 in 157 patients with spinal dura mater injury. There were 25 female and 43 male pa-tients with an average age of(37. 6 ± 9. 3)years(range:23~59)in 68 patients with cerebrospinal fluid leakage after opera-tion. And there were 30 cases in DT-1,12 in DT-2,18 in DT-3,1 in DT-4,7 in DT-5. No case was found cerebrospinal fluid ef-fusion around incision and drainage port after removing the drainage tube. No case with the dura mater pseudocyst was found. All incision healed by first intention. Conclusion Prolonged drainage is an effective ways of remedying cerebrospinal fluid leakage after posterior spinal surgery.