The drainage volume control by elevation of drainage height versus head down tilt in supine position for management of cerebrospinal fluid leakage following lumbar posterior surgery.

Autor: Dong P; Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China., Huang J; Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China., Deng X; Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China., Yang H; Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China., Luo C; Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China. luochunmei@tmmu.edu.cn.
Jazyk: angličtina
Zdroj: BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2024 Nov 14; Vol. 25 (1), pp. 910. Date of Electronic Publication: 2024 Nov 14.
DOI: 10.1186/s12891-024-08040-6
Abstrakt: Objective: To compare the clinical outcomes of control of drainage volume through either elevating the drainage height or tilting the head down in a supine position for the management of cerebrospinal fluid leakage (CSFL) following posterior lumbar surgery.
Methods: A retrospective analysis was conducted to review the data of patients who underwent lumbar spine surgery at a single hospital over a 4-year period from January 2020 to December 2023. Postoperative CSFL and complications were recorded. All patients with CSFL were managed with bed rest, a 20-30° head-down tilt position, or a drainage system elevated by 10 cm, along with subfascial drains, for a duration of 3 days. The clinical outcomes of drainage volume control were compared between the elevation of the drainage system and the head-down tilt position in the supine posture.
Results: The incidence of CSFL after lumbar surgeries was 1.2% (84 out of 7,284 cases). None of the CSFL patients experienced significant complications or required reoperation. When compared to the traditional Trendelenburg position, elevating the drainage height reduced the incidence of headache and dizziness, as well as shortened the time to ambulation, postoperative defecation time, and postoperative hospital stay, with statistically significant differences (p < 0.05).
Conclusion: Postoperative drainage volume control using the Trendelenburg position or elevation of the drainage height is both safe and effective for the management of CSFL. The method involving a 10 cm elevation of the drainage system appears to be an easier and more clinically acceptable approach for the nursing care of CSFL following posterior lumbar surgery.
Competing Interests: Declarations Ethics approval and consent to participate This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Medical Ethics Committee of Xinqiao Hospital, Army Medical University ((Reference number 2024-YD228-01). Written informed consent was obtained from all the participants. Consent for publication Not applicable. Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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