腰椎术后脑脊液漏治疗的研究进展

Research Progress in the Treatment of Cerebrospinal Fluid Leakage after Lumbar Spine Surgery

摘要: 由于脊柱手术的复杂性，硬脑膜撕裂导致脑脊液(CSF)渗漏的患病率很高。许多研究集中在硬脑膜撕裂的缝合修复上，以阻止脑脊液渗漏。现在，一些新的治疗策略已经显示出有希望的效果，如下所示：1) 在硬脑膜替代材料的帮助下创建水密硬脑膜闭合以阻止脑脊液渗漏；2) 通过改变压差来延缓脑脊液渗漏，包括降低蛛网膜下腔液体压力、增加硬膜外腔压力等。事实上，上面提到的几种方法通常结合起来治疗脑脊液漏。然而，没有更新的综述总结近年来实施的相关研究。本文将总结常用的治疗脑脊液漏的方法，并介绍最新的治疗方法和机制。

Abstract: Due to the intricacies of spinal surgery, there is a high incidence of dural tear leading to cerebro-spinal fluid (CSF) leakage. Much research has focused on the suture repair of dural tears to prevent CSF leakage. Now, some novel therapeutic strategies have shown promising effects, including: 1) creating an impermeable dural closure with the aid of dural substitute materials to prevent CSF leakage; 2) slowing the CSF leakage by altering pressure differentials, such as reducing subarach-noid fluid pressure and increasing epidural pressure. In practice, these methods are often com-bined to treat CSF leakage. However, there is no updated review summarizing the relevant studies conducted in recent years. This article will summarize the commonly used methods for treating CSF leakage and introduce the latest treatment methods and mechanisms.