کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3095243 1581474 2014 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Comparison of Symptomatic Cerebral Spinal Fluid Leak Between Patients Undergoing Minimally Invasive versus Open Lumbar Foraminotomy, Discectomy, or Laminectomy
ترجمه فارسی عنوان
مقایسه مقادیر نشت مایع مغزی نخاعی مایع مغزی در بین بیماران مبتلا به فرومینیومی کمری، مجاری معده، دیسکتومی یا لامینکتومی
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی عصب شناسی
چکیده انگلیسی

ObjectiveMinimally invasive spine surgery (MISS) techniques have similar long-term outcomes compared to open surgery for patients undergoing 1- or 2-level discectomy, foraminotomy, or laminectomy. However, the rate of cerebrospinal fluid (CSF) leaks with both techniques has not been well established in the literature. This study sought to compare the rate and clinical impact of CSF leak in open lumbar foraminotomy, discectomy, or laminectomy with comparable MISS approaches.MethodsA total of 863 patients undergoing 1- or 2-level discectomy, foraminotomy, or laminectomy by either MISS an open technique were evaluated for CSF leaks. Variables assessed included operative time, blood loss, CSF leaks, hospital stay, days with lumbar drain, days of postoperative flat bed rest, and postoperative intervention. Statistical analyses include univariate analysis (Student t test, analysis of variance, odds ratio, χ2) and bivariate analysis (logistic regression).ResultsIn the MISS group there were 15 CSF leaks (4.7%), and 49 CSF leaks (9.0%) in the open group. Eight patients in the open group required lumbar drainage, compared to zero patients in the MISS group. Twelve patients required reoperation for persistent CSF leak in the open group, compared to zero patients in the MISS group. Patients undergoing open spine surgery were 2 times more likely to have a CSF leak (odds ratio = 2.3, 95% confidence interval = 1.2 to 3.7, P = .01). Patients undergoing MISS had significantly lower reoperation rates for CSF leak repairs (open = 25% of open CSF leak cases, MISS = 0%, P < .01).ConclusionsIn this study, there was a statistically significant decreased rate of CSF leak between an MISS approach and an open surgical approach. Furthermore, CSF leaks in open surgery have a higher probability of requiring lumbar drainage or reoperation to repair the durotomy.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: World Neurosurgery - Volume 81, Issues 3–4, March–April 2014, Pages 634–640
نویسندگان
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