Comparison of therapeutic effect of different treatments for cerebrospinal fluid leakage induced by surgical operation of spinal fracture combined with dural injury / 中华创伤杂志

ABSTRACT

Objective To compare the therapeutic effect of three treatments for cerebrospinal fluid leakage induced by surgical operation of spinal fracture combined with dural injury.Methods From June 2005 to June 2010,64 patients with cerebrospinal fluid leakage after surgery to spinal fracture combined with dural injury were analyzed.Patients were treated with positioning adjustment and incision pressure dressing (Group A,n =21),with cerebrospinal fluid leakage drainage via a lumbar percutaneous subarachnoid catheter (Group B,n =21),and with continuous wound drainage followed by catheter removing and wound closure when wound is completely healed (Group C,n =22).Time to stop cerebrospinal fluid leaking from a surgical incision,wound healing time,success rate in the primary intervention and postoperative complications were reviewed among these groups.Results In Group A,the incisional cerebrospinal fluid leakage disappeared at (19.0 ±3.9)days,with healing time of (25.0 ± 4.6)days.The primary wound healing was achieved in 13 patients but failure to the primary intervention occurred in 8 patients,of whom 6 patients presented complications which were then cured.In Group B,the incisional cerebrospinal fluid leakage disappeared at (3.0 ± 1.0) days,with healing time of (16.0 ± 2.6) days.There were 15 patients with primary wound healing but 6 patients got healing after further treatment,with no complications occurred.In Group C,there was no incisonal cerebrospinal fluid leakage or complications and all patients presented primary wound healing in a period of (13.0± 1.0)days.Healing time was shorter and success rate in the primary intervention in Group C was higher than those in Groups A and B (P ＜ 0.05).Conclusions Continuous wound drainage till catheter removal and wound closure on complete wound healing is a good choice for treating cerebrospinal fluid leakage induced by surgical operation of spinal fracture combined with dural injury,for it has advantages of good incisional healing,high success rate and few complications in the primary treatment.