Dural Tears and Cerebrospinal Fluid Leak in Osteotomy Surgery for Ankylosing Spondylitis: Incidence, Risk Factors

• DOI: 10.1111/os.70036
• Publication Date: 2025-04-05T01:32:06Z
• Authors: Yue Huang; Fuze Liu; Yifei Li; Qi Zhu; Hai Wang; Jianguo Zhang
• Keywords: Cerebrospinal fluid leak; Kyphosis

The osteotomy surgery for ankylosing spondylitis (AS) presents a higher risk of dural injury and cerebrospinal fluid leakage compared to conventional spinal surgical procedures. However, there is currently lack systematic summaries in this field. This study aims present the incidence factors associated with tears (CSF) during corrective procedures AS kyphotic deformity. A retrospective analysis was conducted on patients diagnosed our hospital between June 2014 May 2024 who presented deformity underwent osteotomy, specifically pedicle subtraction (PSO) or Smith-Petersen (SPO). total 110 were included investigation. Among them, 98 PSO (69 received single-segment PSO; 29 double-segment PSO), while 12 SPO. mean age participants at time 36.25 years (ranging from 21 59 years). Of cohort, intraoperative occurred 37 patients. Radiological parameters-including sagittal vertical axis (SVA), kyphosis angle, posterior epidural space thickness segment, alignment vertebral canal Andersson lesions, ossification-were assessed using spine radiographs computed tomography (CT) scans analyzed via Surgimap software. continuous variables mentioned above primarily groups independent samples t test, categorical mainly through chi-square test Fisher's exact intergroup comparisons. Additionally, binary logistic regression employed further validate undergoing osteotomy. overall found be 33.6%. Specifically, recorded 36.4%, whereas it only 9.1% SPO upper lumbar segment highest probability summarizes imaging characteristics PSO, revealing that those experience CSF typically smaller site prevalence lesions ossification. multiple linear model indicates reduced site, along ossification, are significant following surgery. accidental rate Factors such as Anderson ossification observed CT serve predictors comprehensive preoperative assessment can provide valuable guidance regarding potential occurrence leakage.