腰椎全椎间盘置换术后脑脊液漏：诊断和治疗挑战。
Postoperative Cerebrospinal Fluid Leak After Lumbar Total Disc Replacement: A Diagnostic and Management Challenge.
机构信息
Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, California, USA.
Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles, California, USA.
出版信息
World Neurosurg. 2020 May;137:119-125. doi: 10.1016/j.wneu.2020.01.226. Epub 2020 Feb 5.
BACKGROUND
Lumbar total disc replacement is increasingly becoming a more common treatment for discogenic low back pain refractory to conservative measures. Nevertheless, several complications have been reported, including, among others, wound infection, vascular injury, retrograde ejaculation, postsympathectomy syndrome, ileus, and cerebrospinal fluid (CSF) leak. Although CSF leakage is rare, we discuss a case of CSF leakage and the diagnosis and management of CSF leakage after lumbar total disc replacement.
CASE DESCRIPTION
A 25-year-old man had presented with discogenic low back pain caused by degenerative disc disease of 9 years' duration. His symptoms were exacerbated by activity, worse with sitting, and relieved by ice baths. He developed a cerebrospinal fluid leak after L5-S1 lumbar total disc replacement.
CONCLUSIONS
Our patient ultimately required device removal, direct repair, and replacement with a different prosthesis to treat his CSF leak.
背景
腰椎间盘置换术越来越多地成为一种治疗对保守治疗无效的椎间盘源性腰痛的常见方法。然而，已经报告了一些并发症，包括伤口感染、血管损伤、逆行射精、交感神经切除后综合征、肠梗阻和脑脊液（CSF）漏。尽管 CSF 漏很少见，但我们讨论了一例 CSF 漏病例以及腰椎间盘置换术后 CSF 漏的诊断和处理。
病例描述
一名 25 岁男性因退行性椎间盘疾病导致腰痛 9 年，表现为椎间盘源性腰痛，活动后加重，坐位时加重，冰敷后缓解。他在 L5-S1 腰椎间盘置换术后发生了脑脊液漏。
结论
我们的患者最终需要移除器械、直接修复，并更换不同的假体来治疗他的 CSF 漏。
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