人工硬脊膜联合生物蛋白胶修复颈椎术中硬脊膜损伤  

Artificial dura combined with biological protein glue repair cervical dural tears during cervical spine surgery

作　　者：廖晖[1] 徐卫国[1] 李锋[1] 熊伟[1] 方忠[1] 陈安民[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院骨科,湖北武汉430030

出　　处：《生物骨科材料与临床研究》2012年第4期17-19,共3页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨颈椎术中硬脊膜损伤的治疗方法及其临床疗效。方法 2006年6月-2011年6月期间,行颈椎手术过程中处理颈椎硬脊膜损伤并脑脊液漏患者31例,其中颈椎外伤性骨折脱位12例,颈椎病14例,颈椎硬膜下髓外肿瘤4例,颈椎肿瘤1例。所有患者在术中均予人工硬脊膜覆盖联合生物蛋白胶喷涂的方法进行修补。结果经处理后,29例患者术后未出现脑脊液漏症状,2例脑脊液漏患者中1例经局部压迫愈合,另1例经联合持续腰椎蛛网膜下腔引流愈合。经平均18个月﹙6-35个月﹚随访,本组患者均未出现再发脑脊液漏、假性脑脊膜囊肿、颈椎植骨融合不良等并发症。结论采用人工硬脊膜联合生物蛋白胶修复颈椎硬脊膜损伤具有简易、可靠、有效降低术后脑脊液漏的发生率的优点。Objective To explore the management of cervical dural tears during cervical spine surgery. Methods 31 pa- tients with cervical dural tears and cerebrospinal fluid leak were identified at the time of cervical spine surgery. 12 cases were caused by cervical spine injure, the other 19 cases were caused by iatrogenic injury during cervical spine surgery. All patients with cervical dural tears were repaired by artificial dura and biological protein glue during cervical spine sur- gery. Results All patients were followed for an average of 18 months （ ranged from 6 to 35 months ） postoperatively. No cerebrospinal fluid leak was occurred in 29 patients. In the rest of 2 patients with cerebrospinal fluid leak, one was cured in 3 days by local pression. The other one was cured by continued lumbar cerebrospinal fluid drain after cervical spine surgery. No complication associated with cerebrospinal fluid leaks of all these patients were observed. Conclusion Repair of cervical dural tears with artificial dura combined with biological protein glue was a simple but effective method of reducing the incidence of cerebrospinal fluid leaks.

关 键 词：颈椎 并发症 脑脊液漏 人工硬脊膜 生物蛋白胶 

分 类 号：R681.5[医药卫生—骨科学]