Abstract:

Objective　To analyze the relationship between the repair method of  dura mater after and cerebrospinal fluid leakage(CSFL).   Methods    From Jan. 2010 to Dec. 2016, 200 patients with subdural tumors were treated by posterior surgery, including 89 males and 111 females, with an average age of 46.2 years (4 months -82 years). Radiological images of fractures, internal fixation, repair method of dura mater, occurrence of CSFL and its treatment were recorded and analyzed after follow-up.    Results   CSFL was found in 26 of the 200 patients after operation. 85 cases were treated with internal fixation, of which 22 cases had CSFL (25.9%). 115 cases did not place internal fixation, of which 4 cases had CSFL (3.5%). There were 30 cases of simple suture of dura, of which 8 cases had CSFL (26.7%). 136 cases had spinal membrane sutured and covered, of which 16 cases had CSFL (11.8%); 29 cases had spinal membrane sutured and covered with protein glue, of which 2 cases had CSFL (6.9%). 5 cases were repaired by myofascial or fat because of dural defects, and did not show CSFL. The incidence of CSFL in patients with  coverage of the spinal membrane or (and) biological protein gum, myofascia or fat after suture of the dura was statistically significant (P<0.05). In 10 patients with leakage of cerebrospinal fluid that underwent extended drainage time, there was no incision complications, and the average time for stitch removal was 11.8±1.7 days; and 2 cases in 16 patientswith early removal of drainage tube developed intracranial infection, 1 cases sinus tract, 1 cases dural pseudocyst formation, the average time for stitch removal was 18.5±8.5 days, and the difference were statistically significant (P<0.05). Conclusion    Placement of internal fixation in the surgery of subdural tumor can increase the incidence of CSFL. Spinal dura mater, fibrin glue, myofascial or fat repair dura can reduce CSFL. The proper extension of the drainage time after the CSFL after operation can promote the healing of the incision and reduce the incidence of related complications.

Key words: Subdural tumor;  , Cerebrospinal fluid leakage; , Internal fixation;　Surgery;  , Drainage tube