Xiao Yu, Wang Bing, Chen Yulian, Chen Lingqiang, Lou Zhenkai, Gong Zhiqiang
Department of Orthopaedics, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
Department of ENT, The First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
Neurospine. 2023 Mar;20(1):255-264. doi: 10.14245/ns.2244772.386. Epub 2023 Mar 31.
To identify potential risk factors for cerebrospinal fluid (CSF) leakage after craniovertebral junction (CVJ) anomaly surgery and to provide a reference for clinical practice.
Sixty-six patients who underwent elective CVJ anomaly surgery during a 6-year period (April 2013 to September 2019) were retrospectively included. Research data were collected from the patients' medical records and imaging systems. Patients were divided into CSF leak and no CSF leak groups. Univariate tests were performed to identify potential risk factors. For statistically significant variables in the univariate tests, a logistic regression test was used to identify independent risk factors for CSF leakage.
The overall prevalence of CSF leakage was 13.64%. Univariate tests showed that a basion-dental interval (BDI) > 10 mm and occipitalized atlas had significant intergroup differences (p < 0.05). Multivariate analysis indicated that a BDI > 10 mm was an independent risk factor for CSF leakage, and patients with CVJ anomalies with a BDI > 10 mm were more likely to have postoperative CSF leaks (odds ratio, 14.67; 95% confidence interval, 1.48-30.88; p = 0.004).
It is necessary to maintain vigilance during CVJ anomaly surgery in patients with a preoperative BDI > 10 mm to avoid postoperative CSF leaks.
确定颅颈交界区（CVJ）畸形手术后脑脊液（CSF）漏的潜在危险因素，为临床实践提供参考。
回顾性纳入66例在6年期间（2013年4月至2019年9月）接受择期CVJ畸形手术的患者。研究数据从患者的病历和影像系统中收集。患者分为脑脊液漏组和无脑脊液漏组。进行单因素检验以确定潜在危险因素。对于单因素检验中有统计学意义的变量，采用逻辑回归检验确定脑脊液漏的独立危险因素。
脑脊液漏的总体发生率为13.64%。单因素检验显示，基底齿突间距（BDI）>10mm和枕骨化寰椎组间差异有统计学意义（p<0.05）。多因素分析表明，BDI>10mm是脑脊液漏的独立危险因素，BDI>10mm的CVJ畸形患者术后更易发生脑脊液漏（比值比，14.67；95%置信区间，1.48 - 30.88；p = 0.004）。
对于术前BDI>10mm的CVJ畸形患者，在手术期间有必要保持警惕，以避免术后脑脊液漏。
