Menon Sajesh K, Onyia Chiazor U
Division of Spine surgery, Department of Neurosurgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
Neurosurgery Division, Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
Clin Neurol Neurosurg. 2015 Dec;139:248-51. doi: 10.1016/j.clineuro.2015.10.013. Epub 2015 Oct 23.
Cerebrospinal fluid (CSF) leak is a common complication of surgery involving the lumbar spine. 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 work in the literature on the various factors and technical errors during or after lumbar spine surgery that may lead to this feared complication, the available options of management with focus on the various techniques employed, the outcomes and also to highlight on the current trends. We also discuss the presentation, factors contributing to its development, basic concepts and practical aspects of the management with emphasis on the different techniques of treatment. Different outcomes following various techniques of managing post-operative CSF leak after lumbar spine surgery have been well described in the literature. However, there is currently no most ideal technique among the available options. The choice of which technique to be applied in each case is dependent on each surgeon's cumulative experience as well as a clear understanding of the contributory underlying factors in each patient, the nature and site of the leak, the available facilities and equipment.
脑脊液漏是腰椎手术常见的并发症。在过去几十年里，人们对腰椎手术后脑脊液漏的病因、管理和治疗技术的认识有了显著进展。在本文中，我们回顾了文献中关于腰椎手术期间或术后可能导致这种可怕并发症的各种因素和技术失误、以所采用的各种技术为重点的可用管理选项、结果，并强调当前的趋势。我们还讨论了其表现、导致其发生的因素、管理的基本概念和实际方面，重点是不同的治疗技术。文献中已经很好地描述了腰椎手术后采用各种技术处理脑脊液漏的不同结果。然而，目前在可用选项中没有最理想的技术。在每种情况下应用哪种技术的选择取决于每位外科医生的累积经验，以及对每位患者潜在促成因素、漏口的性质和部位、可用设施和设备的清晰理解。
