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How to locate the dural defect in a spinal extradural meningeal cyst: a literature review

Chinese Neurosurgical Journal 2022年第3期8卷 195-205页

作者： Qiang Jian Zhenlei Liu Wanru Duan Fengzeng Jian Zan Chen Department of Neurosurgery Xuanwu HospitalCapital Medical UniversityBeijing 100053China

Spinal extradural meningeal cysts(SEMCs)are rare lesions of the spinal *** closure of the dural defect can achieve satisfactory therapeutic effects,locating the fistula is *** review summarizes the methods for locating the fistula of SEMCs and the distribution and features of fistula *** was a non-systematic literature review of studies on *** searched PubMed for English-language articles to summarize the methods of locating the *** search words were“epidural arachnoid cyst,”“dural cyst,”“epidural cyst,”and“epidural meningeal cyst.”For the defect location component of the study,case reports,studies with a sample size less than four,controversial ventral dural dissection(s),and undocumented fistula location reports were *** review showed that radiography and computed tomography(CT)may show changes in the bony structure of the spine,with the largest segment of change indicating the fistula ***,magnetic resonance imaging(MRI)can show a cerebrospinal fluid(CSF)flow void at the fistula *** middle segment of the cyst on sagittal MRI,the largest cyst area,and cyst laterality in the axial view indicate the fistula *** can show the fistula location in the area of the enhanced cyst and subarachnoid *** subtraction or delayed CT can be used to observe the location of the initial cyst *** MRI and time-spatial labeling inversion pulse techniques can be used to observe CSF ***-state image construction interference sequence MRI has a high spatial ***,MRI myelography,and ultrasound fistula detection can be performed ***,the fistula was located most often in the T12–L1 *** the fistula location is difficult and requires a combination of multiple examinations and experience for comprehensive judgment.

关键词： Spinal extradural meningeal cyst dural cyst dural defect Communication Fistula

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Clinical management of dural defects:A review

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World Journal of Clinical Cases 2023年第13期11卷 2903-2915页

作者： Rong-Peng Dong Qi Zhang Li-Li Yang Xue-Liang Cheng Jian-Wu Zhao Department of Spinal Surgery The Second Hospital of Jilin UniversityChangchun 130000Jilin ProvinceChina

dural defects are common in spinal and cranial neurosurgery.A series of complications,such as cerebrospinal fluid leakage,occur after rupture of the ***,treatment strategies are necessary to reduce or avoid *** review comprehensively summarizes the common causes,risk factors,clinical complications,and repair methods of dural *** latest research progress on dural repair methods and materials is summarized,including direct sutures,grafts,biomaterials,non-biomaterial materials,and composites formed by different *** characteristics and efficacy of these dural substitutes are reviewed,and these materials and methods are systematically ***,the best methods for dural repair and the challenges and future prospects of new dural repair materials are discussed.

关键词： dural defect Cerebrospinal fluid leak Incidental durotomy Causes of dural defect dural repair

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Prolonged wound drainage in the management of cerebrospinal fluid leakage following posterior spinal surgery

Prolonged wound drainage in the management of cerebrospinal ...

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第20届中国康协肢残康复学术年会

作者：孔清泉李涛龚全宋跃明刘浩曾建成张立陈仲强四川大学华西医院骨科北京大学第三医院

[Study Design]Retrospective[Objective]To assess the clinical efficacy of prolonged wound drainage on postoperative cerebrospinal fluid(CSF)leakages,by comparison with the short-term wound drainage therapy.[Summary of Background Data]Various techniques have been used to treat CSF leakages following spine surgery,each of which has its own inherent risks and ***,prolonged wound drainage reported by Huges may be a simple and reliable technique to deal with this *** there are fewer reports about the efficacy and reliability of this technique,especially from a sample on a relatively larger scale.[Methods]A retrospective study was performed in 151 patients with intraoperative and/or postoperative CSF leakages who had undergone posterior spinal surgeries between February 2000 and December 2007.88 patients with postoperative CSF leakages were classified into short-term drainage group(≤3 days,43 cases)and long-term drainage group(≥5 days,45 cases),mainly in accordance with drainage *** collected included patient age,clinic diagnosis,approach performed,intraoperative findings,methods of dural defect closure,duration of wound drainage when applicable,length of hospital stay,duration of follow-up,and complications[Results]Among 88patients with postoperative CSF leakages,58 patients had been recorded with the occurrence of intraoperative CSF *** incidence of cutaneous leakage was 88.9%(40/45)in short-term drainage group,whereas,only4.7%(2/43)in long-term *** incision healing time and length of hospital stay were both more prolonged in short-term group than that in long-term *** were no wound infection,meningitis,and pal-pable subcutaneous fluid retention in long-term group.[Conclusion]Prolonged wound drainage is a reliable and simple technique to treat postoperative CSF leakages,especially for persistent leakages,without prolonging the healing time and increasing postoperative infection incidence.

关键词： spine dural defect CSF leakage surgery

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