International Journal of Clinical Research

Objective: To compare the clinical efficacy of free paraspinal muscle flap packing, artificial dura mater repair and dural suture in the treatment of intraoperative nerve root axillary dura mater rupture. Methods: Thirty-four patients with spinal diseases who had nerve root axillary dura rupture in more than 600 cases of spinal surgery in Delconi orthopedic hospital from January 2018 to July 2021 were selected. The patients were divided into group A: simple suture group (10 cases), group B: simple artificial dural repair group (12 cases), and group C: free paraspinal muscle flap packing group (12 cases), and they were given routine antibiotics after operation. Treatment, recording the postoperative drainage volume, drainage time, the occurrence of postoperative cerebrospinal fluid leakage, whether there is effusion and infection in the incision, and whether there is a pseudodural cyst after the postoperative imaging review, and compare the three groups of patients with low back pain before and after surgery , VAS score of leg pain, and SF-36 quality of life scale was used to evaluate the quality of life before and after surgery. Results: There was no statistical difference in gender, age and other general information of the three groups of patients (P>0.05), which was comparable. The drainage volume of free paravertebral muscle flap tamponade treatment at 1, 2, and 3 days after operation was less than that of the simple artificial dura mater group, and was less than that of the simple suture group, and the differences were statistically significant (P<0.05). The drainage volume of the free paravertebral muscle flap on the 1st day after tamponade was more than that on the 2nd and 3rd day after the operation, and the difference was statistically significant (P<0.05). The postoperative back pain VAS score, leg pain VAS score, the incidence of cerebrospinal fluid leakage, the incidence of infection and the incidence of pseudodural cyst in group C were lower than those in group A and group B, and the differences were statistically significant (P<0.05). Conclusion: The use of free paraspinal muscle flap packing has a good effect in the treatment of patients with nerve root axillary dural rupture during operation, and it is worthy of clinical promotion.

Spinal Diseases; Ruptured Dura Mater; Artificial Dura Mater; Free Muscle Flap