Extended drainage time and intermittent clamping of the drainage tube for spinal cerebrospinal fluid leakage after spinal surgery

English Keywords:Spinal surgery  Cerebrospinal fluid leakage  Complications  Treatment

English Abstract:

  【Abstract】 Objective：To evaluate the clinical outcome of extending drainage time and intermittent clamping of the drainage tube for spinal cerebrospinal fluid leakage after spinal surgery.Method：From December 1999 to December 2009，a total of 1400 patients underwent spinal surgery in our institute.Postoperative cerebrospinal fluid leakage occurred in 31 cases，who were 19 males and 12 females aged from 22 to 70 years old（average， 48.5 years old）.15 cases had wound drainage tubes removed after 3 days and routine wound dressings changed（group A）；while 16 cases experienced extended drainage time and intermittent clamping of the drainage tube（group B）.Antibiotics were used till the wound healed in both groups.The skin incision healing and CSF leaking-related complication were reviewed retrospectively.Result：The cerebrospinal fluid leakage in group A ceased at 20.0±3.8d，and the wound healed at 24.0±4.3d.8 cases had skin incision healed at the primary state of intervention and had CSF leakage ceased at 20d；7 cases did not respond in the primary state of intervention，among who，2 cases underwent dural repairing alone，which was effective until 15d.2 cases were complicated with pseudo-sac cyst，which was resolved by dissection of cyst wall and routine dural repair；3 cases presented with skin incision infection which was resolved by complete debridement and administration of antibiotics.The cerebrospinal fluid leakage in group B ceased at 9.0±1.6d.All skin incision got I stage heal at 14.0±2.5d.No pseudo-sac cyst and infection were noted，which showed significant difference between group A and B with regard to the CSF cease and skin incision healing time（P<0.05）.Conclusion:Extended drainage time and intermittent clamping of the drainage tube for spinal cerebrospinal fluid leakage after spinal surgery is more effective and reliable than conventional intervention.