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| MENG Yang,SHEN Bin,ZHANG Yan.Multivariate analysis of risk factors for cerebrospinal fluid leakage following lumbar laminectomy decompression with fusion[J].Chinese Journal of Spine and Spinal Cord,2013,(4):330-334. |
| Multivariate analysis of risk factors for cerebrospinal fluid leakage following lumbar laminectomy decompression with fusion |
| Received:October 23, 2012 Revised:December 01, 2012 |
| English Keywords:Lumbar Spinal fusion Cerebrospinal fluid leakage Risk factors Logistic regression |
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| English Abstract: |
| 【Abstract】 Objectives: To elucidate the prevalence of cerebrospinal fluid(CSF) leakage and explore its risk factors following lumbar laminectomy decompression with fusion, in addition, to provide references for prevention and managements. Methods: A total of 758 patients undergoing lumbar laminectomy decompression with fusion due to lumbar spinal stenosis was eligible for this study during January 2001 and December 2011. Data of age, gender, smoking history, alcohol use, diabetes, body mass index(BMI), duration of symptoms, revision surgery, surgical method, presence of intraoperative adjustment of pedicle screws, number of surgical levels, the lowest surgical level and presence of CSF leakage were collected by respectively reviewing patients′ medical records. Patients were divided into two groups according to the presence of CSF leakage. Univariate analysis was firstly used to explore significant factors for CSF leakage, and then these factors were measured by multivariate logistic analysis to identify the risk factors for CSF leakage following lumbar laminectomy decompression with fusion. Results: The incidence of CSF leakage following lumbar laminectomy decompression with fusion was 13.1%(99 of 758 cases). The incidence of CSF leakage following primary surgeries was 10.3%(66 of 638 cases), which compared to an incidence of 27.5% for revision surgery(33 of 120 cases). Of 99 cases with CSF leakage, 45 cases suffered from dural tear(DT) or CSF leakage during surgery, and 54 patients were complicated with delayed CSF leakage without intraoperative DT or CSF leakage which occurred at 1 to 9 days after surgery. Univariate analysis showed statistical differences in age, smoking, duration of symptoms, revision surgery, number of surgical levels and the lowest surgical level(P<0.05). Multivariate logistic analysis showed the age(OR=2.153, 95% CI=1.045-4.433), smoking(OR=1.615, 95% CI=1.015-2.572), revision surgery(OR=3.386, 95% CI=2.047-5.603), number of surgical levels(OR=2.503, 95% CI=1.580-3.966) and the lowest surgical level(OR=2.391, 95% CI=1.085-5.269) were risk factors for this complication(P<0.05). Conclusions: Age, smoking, revision surgery, number of surgical levels and the lowest surgical level seriously affect the incidence of CSF leakage. |
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