Treatment of Cerebrospinal Fluid Leakage Complicating Post-Spinal Surgery

Cerebrospinal fluid leakage is one of the common complications after spinal surgery, with an incidence of about 2.31%-9.37%. If the treatment is not timely or improperly handled, it can lead to wound infection, intracanalicular infection, and even secondary intracranial infection, which is more serious and may endanger life safety. 1, treatment 1, for the 18 patients found before extubation to extend the extubation time, strengthen the prevention of infection, 7-10 d after surgery to observe good healing of the incision, drainage flow decreased, to be removed from the drainage tube, pressure bandage drainage mouth, cerebrospinal fluid leakage stopped. 2.After extubation, cerebrospinal fluid leak combined with wound infection was found in one case, and the wound was opened and drained for 9 d. At the same time, anti-infection treatment was strengthened, and the pus was basically cleaned, and then the stoma was placed next to the incision with continuous closed flushing, and no bacterial growth was observed on the 3rd and 5th days of flushing, and the flushing was changed to drainage after 7 d. After 10 d of drainage, the incision was observed to be healing well, and the drainage flow was ≤50 ml for 2 d. The drainage tube was removed and pressure bandaged. The cerebrospinal fluid leakage was stopped by applying pressure to the drainage port. 3, after extubation found incision cerebrospinal fluid leakage in strict disinfection after local aspiration of exuded cerebrospinal fluid, strengthen the prevention of infection, with thick pillows on the chest and hip, abdominal suspension prone position incision local sandbag pressure for 3-7 d. Second, the complication of cerebrospinal fluid leakage have the following treatment: 1, extend the extraction time, strengthen the prevention of infection, observe good healing of the incision, the flow of drainage can be reduced to remove the drainage tube, pressure bandage drainage The mouth of the drainage tube should be wrapped with pressure. 2, strengthen the prevention of infection, use thick pillows on the chest and hips, abdomen hanging prone position, in order to reduce the small abdominal pressure, incision local sandbag pressure. 3, the use of continuous lumbar puncture drainage. 4, Maycock method, that is, the patient first lateral recumbency, draw out the cerebrospinal fluid leaking in the subcutaneous, and then in the epidural rupture of the supraspinal vertebral body of the epidural puncture, and then change to sitting position after success, by another operator from the patient’s forearm puncture to draw 25ml of venous blood, injected into the epidural space, injection should be observed when the patient has no discomfort, injection has no resistance. The treatment principle is to use the autologous blood injected into the epidural space to inject downward to the ruptured epidural opening, forming a blood clot in the area to block the opening. 5, secondary surgery to repair the ruptured dura, its indications are the last resort in the case of ineffective use of other methods.