UNASSIGNED:本研究旨在通过脂肪移植物和椎旁肌皮瓣的组合提出一种新颖的手术方法,为了治疗胸腰椎后路手术中的脑脊液(CSF)漏。还评估了临床结果。
UNASSIGNED:回顾性收集并分析了2019年1月至2021年1月我院收治的71例胸腰椎后路手术后被诊断为术中偶然切开和脑脊液漏的患者的数据。其中,将34例和37例患者分为传统缝合(CS)组和脂肪移植和椎旁肌皮瓣(FPM)组,分别。比较两组患者的人口统计学和临床资料。
UNASSIGNED:FPM组的平均引流管时间为3.89±1.17天,短于CS组(5.12±1.56,P<0.001)。FPM组的引流量(281.08±284.76ml)也小于CS组(859.70±553.11ml,P<0.001)。此外,CS组15例(44.11%)患者主诉体位性头痛,这比FPM组(7名患者,18.91%)。两组患者术后视觉模拟评分(VAS)评分差异有统计学意义(P=0.013)。两名患者因切口不愈合和延迟性脑膜囊肿而接受了翻修手术。
UNASSIGNED:脂肪移植结合椎旁肌皮瓣显示出一种在胸腰椎后路手术中修复CSF渗漏的有效方法。所提出的方法显着减少了术后引流管时间和术后引流量。它还降低了姿势性头痛的发生率和程度。所提出的方法显示了令人满意的临床结果,值得推广。
UNASSIGNED: This study aimed to propose a novel surgical method via combination of fat graft and paraspinal muscle flap, in order to treat cerebrospinal fluid (CSF) leak during posterior thoracolumbar surgery. The clinical outcomes were also evaluated.
UNASSIGNED: Data of a total of 71 patients who were diagnosed with intraoperative incidental durotomy and CSF leak after posterior thoracolumbar surgery in our hospital form January 2019 to January 2021 were retrospectively collected and analyzed. Among them, 34 and 37 patients were assigned into conventional suturing (CS) group and fat graft and paraspinal muscle flap (FPM) group, respectively. Patients\' demographic and clinical data were compared between the two groups.
UNASSIGNED: The average drainage tube time in the FPM group was 3.89 ± 1.17 days, which was shorter than that in the CS group (5.12 ± 1.56, P < 0.001). The drainage volume in the FPM group (281.08 ± 284.76 ml) was also smaller than that in the CS group (859.70 ± 553.11 ml, P < 0.001). Besides, 15 (44.11%) patients in the CS group complained of postural headache, which was more than that in the FPM group (7 patients, 18.91%). There was a statistically significant difference in postoperative visual analogue scale (VAS) score between the two groups (P = 0.013). Two patients underwent revision surgery resulting from incision nonunion and delayed meningeal cyst.
UNASSIGNED: Fat graft combined with paraspinal muscle flap showed to be an effective method to repair CSF leak during posterior thoracolumbar surgery. The proposed method significantly reduced postoperative drainage tube time and postoperative drainage volume. It also decreased the incidence and the degree of postural headache. The proposed method showed satisfactory clinical outcomes, and it is worthy of promotion.