退行性腰椎滑脱术后脑脊液漏的发生率及原因分析

发布时间：2018-02-23 03:01

本文关键词： 退行性腰椎滑脱脑脊液漏硬脊膜损伤危险因素　出处：《中国脊柱脊髓杂志》2016年07期 　论文类型：期刊论文

【摘要】：目的:探讨退行性腰椎滑脱术后脑脊液漏的发生率及危险因素,为临床预防脑脊液漏的发生提供依据。方法:收集我院2008年1月~2014年12月收治的201例单节段退行性腰椎滑脱初次手术患者的病史资料,根据是否并发脑脊液漏分为观察组和对照组,分析患者的性别、年龄、吸烟史、饮酒史、是否合并糖尿病、体重指数(body mass index,BMI)、手术方式[腰椎后路椎间融合(PLIF)或经椎间孔椎间融合(TLIF)]、滑脱部位、滑脱程度(Meyerding分度)、手术时间及术者年资与术后脑脊液漏发生率的关系。结果:201例患者中共有20例并发脑脊液漏,发生率为9.95%(20/201)。单因素分析结果显示两组病例在手术方式、滑脱程度、手术时间、术者年资方面差异有统计学意义(P0.05);多因素Logistic回归分析显示,手术方式(PLIF与TLIF相比:OR=4.572,95%CI=1.192~17.534)、滑脱程度(Ⅰ度滑脱与Ⅱ度及Ⅱ度以上滑脱相比:OR=0.172,95%CI=0.059~0.500)是退行性腰椎滑脱术后并发脑脊液漏的危险因素(P0.05)。结论:手术方式和滑脱程度影响退行性腰椎滑脱术后脑脊液漏的发生率。
[Abstract]:Objective: to investigate the incidence and risk factors of cerebrospinal fluid leakage after degenerative lumbar spondylolisthesis. Methods: from January 2008 to December 2014, 201 patients with single segmental degenerative lumbar spondylolisthesis were treated in our hospital. According to whether cerebrospinal fluid leakage is complicated or not, they are divided into observation group and control group. The sex, age, smoking history, drinking history and diabetes mellitus of the patients were analyzed. Body mass index (mass), body mass index (BMI), surgical procedure [posterior lumbar intervertebral fusion (PLIFF) or transforaminal fusion (TLIF)], site of spondylolisthesis, Results 20 of 201 patients (9.95% 20 / 201) had cerebrospinal fluid leakage. Univariate analysis showed that there were two groups of patients in the two groups, and the results of univariate analysis showed that there were two groups of patients with cerebrospinal fluid leakage (CSF leakage), and the results of univariate analysis showed that the two groups had cerebrospinal fluid leakage (CSF) in the two groups, and the results of univariate analysis showed that there were 20 cases of cerebrospinal fluid leakage in the two groups. There were significant differences in degree of slippage, time of operation, seniority of the operator (P 0.05). Multivariate Logistic regression analysis showed that, Compared with TLIF, PLIF is a risk factor for cerebrospinal fluid leakage after degenerative spondylolisthesis. Conclusion: surgical procedure and degree of spondylolisthesis influence the degree of spondylolisthesis. Conclusion: the degree of spondylolisthesis and the degree of spondylolisthesis are the risk factors of cerebrospinal fluid leakage after degenerative spondylolisthesis. Conclusion: the degree of spondylolisthesis and the degree of spondylolisthesis affect the degree of spondylolisthesis and the risk factor of cerebrospinal fluid leakage after degenerative spondylolisthesis. Incidence of cerebrospinal fluid leakage after lumbar spondylolisthesis.
【作者单位】：陆军总医院骨科;
【分类号】：R687.3

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