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在前脊椎外科手术中持续的撕裂和脑脊液泄漏:病理生理学,管理和不断发展的修复技术

Jae Jun Yang¹, Jiwon Park², Jong-Beom Park³

¹Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital, Ilsan 10326, Republic of Korea.

Journal of clinical medicine

|December 11, 2025

概括

持续的撕裂和CSF泄漏是前椎手术中的严重风险,特别是后纵带带骨化. 管理涉及维护皮质的技术和受控的术后护理,以成功修复.

科学领域:

神经外科神经外科
脊柱外科手术脊柱外科手术
手术并发症手术并发症

背景情况:

持续性撕裂 (DT) 和脑脊液 (CSF) 泄漏是前椎手术中不常见但严重的风险.
病例发生率在患有后纵带带骨化 (OPLL) 的患者显著增加,高达32%,在持续骨化 (DO) 患者中超过60%.
OPLL患者的骨纤维变化会在减压过程中造成脆弱的手术平面,容易撕裂.

研究的目的:

审查病理生理学,风险因素,以及在前椎手术中对DT和CSF泄漏的管理.
为风险分层提供一个框架,并概述不断发展的维修技术.
区分既定实践和新兴技术来管理这些并发症,特别是在OPLL的情况下.

主要方法:

对前椎外科手术中持续撕裂和CSF泄漏的现有证据的系统审查.
分析病理生理学,风险因素,诊断预测因素和管理策略.
对手术内和术后护理的评估,包括新的修复材料和技术.

主要成果:

术内管理已经向使用生物材料和密封剂的耐久性保护解压和多层修复发展.
术后护理侧重于中枢神经液压力调节,伤口管理和早期出行.
大多数DTs通过及时识别和标准化治疗成功管理,尽管持续的病例可能需要先进的干预.

结论:

在前脊椎手术中,持续性撕裂和CSF泄漏,特别是OPLL,需要专门的管理策略.
目前的技术强调维护皮质和生物强化修复,以及精心的术后护理.
新兴技术显示出希望,但需要进一步的临床验证才能广泛采用.

关键词:

前宫脊椎外科手术前宫脊椎手术大脑脊髓液泄漏问题长期维修长期维修持续的撕裂持续的撕裂腰部排水系统腰部排水系统后侧纵向带的骨化.密封剂密封剂密封剂

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