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Reliability of Early Ambulation after Intradural Spine Sur-gery : Risk Factors and a Preventive Method for Cerebro-spinal Fluid Leak Related Complications

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Abstract
Objective : Cerebrospinal fluid leakage related complications (CLC) occasionally occur after intradural spinal surgery. We sought to investigate the effectiveness of early ambulation after intradural spinal surgery and analyze the risk factors for CLC. Methods : For this retrospective cohort study, we enrolled 314 patients who underwent intradural spinal surgery at a single institution. The early group contained 79 patients who started ambulation after 1 day of bedrest without position restrictions, while the late group consisted of 235 patients who started ambulation after at least 3 days of bed rest and were limited to the prone position after surgery. In the early group, Prolene 6-0 was used as the dura suture material, while black silk 5-0 was used as the dura suture material in the late group. Results : The overall incidence rate of CLC was 10.8%. Significant differences between the early and late groups were identified in the rate of CLC (2.5% vs. 13.6%), surgical repair required (1.3% vs. 7.7%), and length of hospital stay (2.99 vs. 9.29 days) (p<0.05). Logistic regression analysis revealed that CLC was associated with practices specific to the late group (p=0.011) and the revision surgery (p=0.022). Conclusion : Using Prolene 6-0 as a dura suture material for intradural spinal surgery resulted in lower CLC rates compared to black silk 5-0 sutures despite a shorter bed rest period. Our findings revealed that suture - needle ratio related to dura defect was the most critical factor for CLC. One-day ambulation after primary dura closure using Prolene 6-0 sutures appears to be a costeffective and safe strategy for intradural spinal surgery.
Author(s)
이수범조대철김경태이영석임승철박진훈
Issued Date
2021
Type
Article
Keyword
Cerebrospinal fluid leakComplicationsDural repairPostoperative careSpinal cord neoplasms.
DOI
10.3340/jkns.2020.0350
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8194
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9856825&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Reliability%20of%20Early%20Ambulation%20after%20Intradural%20Spine%20Sur-gery%20:%20Risk%20Factors%20and%20a%20Preventive%20Method%20for%20Cerebro-spinal%20Fluid%20Leak%20Related%20Complications&amp;offset=0&amp;pcAvailability=true
Publisher
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY
Location
대한민국
Language
영어
ISSN
2005-3711
Citation Volume
64
Citation Number
5
Citation Start Page
799
Citation End Page
807
Appears in Collections:
Medicine > Medicine
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