Multiple factor analysis of cerebrospinal fluid leakage related to cervical spine surgery

English Keywords:Cervical spine surgery  Cerebrospinal fluid leakage  Multivariate analysis  Treatment measures

English Abstract:

  【Abstract】 Objectives: To explore the risk factors of cerebrospinal fluid leakage in cervical spine surgery, and to provide basis and interventions for clinical prevention of cerebrospinal fluid leakage. Methods: Retrospective analysis was made on the clinical data of 514 patients who had cervical spine surgery from January 2013 to December 2016, for patients with cerebrospinal fluid leakage, gender, the BMI, course of disease, history of smoking, drinking, hypertension, diabetes, fracture, cervical disc herniation, cervical spinal canal stenosis, bone hyperplasia, ossification of posterior longitudinal ligament, hypertrophy of flavum ligament, adhesion of spinal dura, surgical approach, and surgical levels, a total of 16 factors which might affect the occurrence of cerebrospinal fluid leakage were documented. Logistic regression analysis was used to investigate the correlation with cerebrospinal fluid leakage, furthermore, its causes and interventions were also explored. Results: Among 514 cases, 25 cases suffered from cerebrospinal fluid leakage, after intraoperative repair or postoperative treatment, the cerebrospinal fluid was no longer leaking after 2-15d, no serious complications occurred, with the incidence rate of 4.9%. Adhesion of spinal dura had the highest incidence of cerebrospinal fluid leakage(38.1%). Multiple factors Logistic regression analysis showed that adhesion of spinal dura, ossification of posterior longitudinal ligament, fracture, and cervical spinal canal stenosis were significantly associated with the incidence of cerebrospinal fluid leakage(P<0.05). Conclusions: Adhesion of spinal dura, ossification of posterior longitudinal ligament, fracture, and cervical spinal canal stenosis are the risk factors for postoperative cerebrospinal fluid leakage, it is necessary to take the corresponding treatment to prevent and respond to the occurrence of cerebrospinal fluid leakage.