Incidence and risk factors of cerebrospinal fluid leakage in surgical treatment of degenerative lumbar spondylolisthesis

English Keywords:Degenerative lumbar spondylolisthesis  Cerebrospinal fluid leakage  Dural tears  Risk factors

English Abstract:

  【Abstract】 Objectives: To evaluate the incidence of cerebrospinal fluid leakage(CSFL), and to explore its risk factors in surgical treatment of degenerative lumbar spondylolisthesis. Methods: From January 2008 to December 2014, 201 patients undergoing primary surgery for degenerative lumbar spondylolisthesis eligible for this study were included. Data including age, gender, smoking history, alcohol use, diabetes, body mass index(BMI), operation method[posterior lumbar interbody fusion(PLIF) or transforaminal lumbar interbody fusion(TLIF)], vertebrae of olisthy, degree of olisthy, operation time, surgeon′s experience and presence of CSF leakage were collected by reviewing patients′ medical records. Patients were divided into two groups according to the presence of CSF leakage. The relationship of these factors and the incidence of CSF leakage following degenerative lumbar spondylolisthesis surgery were analyzed. Results: The incidence of CSF leakage was 9.95%(20/201 cases). Univariate analysis showed statistical differences in degree of olisthy, operation time and surgeon′s experience(P<0.05). Multivariate logistic analysis showed operation method(PLIF vs TLIF: OR=4.572, 95% CI=1.192-17.534) and degree of olisthy(grade Ⅰ vs grade Ⅱ and above: OR=0.172，95% CI=0.059-0.500) were risk factors of CSF leakage(P<0.05). Conclusions: Operation method and degree of olisthy affect the incidence of CSF leakage following lumbar spondylolisthesis surgery.