Ishimoto Yuyu, Kawakami Mamoru, Curtis Elizabeth, Cooper Cyrus, Moriguchi Nami, Nakao Shin-Ichi, Nakagawa Yukihiro
Department of Orthopaedic Surgery, Kinan Hospital, Wakayama, Japan.
Spine Care Center, Wakayama Medical University Kihoku Hospital, Katsuragicho, Japan.
Spine Surg Relat Res. 2019 Sep 20;4(1):95-98. doi: 10.22603/ssrr.2019-0037. eCollection 2020.
Cerebrospinal fluid (CSF) leak is a common complication of surgery involving the lumbar spine. However, although there are various therapeutic options for CSF leak, there is currently no optimal technique, and the choice of therapy often depends on the surgeon's cumulative experience. The aim of this study was to describe the successful treatment of CSF leakage using blood injection therapy along the drain removal tract.
We enrolled 7 consecutive patients who underwent lumbar surgery at our institute. The surgeries performed included decompression in two patients (one microendoscopic surgery), fusion in four, and an epidural cyst resection in one. After finding a CSF leak, we injected about 10 ml of blood from the patient into the drain tract. CSF leak did not recur after the blood injection in any of the seven patients. Following just one day of bed rest, the symptoms of intracranial hypotension disappeared with no instances of worsened symptoms of back pain, lower limb pain or fever.
We propose this route of blood injection therapy as a novel method for the treatment of CSF leak after lumbar surgery.
脑脊液漏是腰椎手术常见的并发症。然而，尽管针对脑脊液漏有多种治疗选择，但目前尚无最佳技术，治疗方法的选择往往取决于外科医生的累积经验。本研究的目的是描述沿引流管拔除路径注射血液治疗脑脊液漏的成功案例。
我们纳入了在我院接受腰椎手术的7例连续患者。手术包括2例减压手术（1例显微内镜手术）、4例融合手术和1例硬膜外囊肿切除术。发现脑脊液漏后，我们从患者体内抽取约10毫升血液注入引流管路径。7例患者注射血液后脑脊液漏均未复发。仅卧床休息一天后，颅内低压症状消失，未出现背痛、下肢疼痛或发热症状加重的情况。
我们提出这种血液注射治疗途径作为腰椎手术后治疗脑脊液漏的一种新方法。
