title: Cerebrospinal Fluid Leakage after Surgeries on the Thoracic Spine: A Review of 362 Cases.
abstract: METHODS
  A retrospective clinical review.
  
  
  OBJECTIVE
  To describe the incidence of cerebrospinal fluid leakage (CSFL) after thoracic decompression and examine the CSFL predisposing clinical factors.
  
  
  BACKGROUND
  CSFL is a common complication following thoracic decompression but has not been sufficiently addressed in former studies.
  
  
  METHODS
  A cohort of 362 cases of thoracic decompression from February of 2005 to June of 2013 was examined. The case medical records were reviewed and the occurrence of CSFL and the related clinical parameters were noted. The incidence of CSFL for the entire cohort and each surgical approach were described. Besides, the relationship between CSFL and other clinical parameters were assessed, of which odds ratio values of all CSFL-associated parameters were calculated using multivariate logistic regression analysis.
  
  
  RESULTS
  The incidence of CSFL for the entire cohort was 32.3%. Different surgical approaches had different incidences of CSFL, and circumferential decompression had the highest incidence. Though many different clinical parameters were related to the occurrences of CSFL, being older than 52 years, having ossification of the posterior longitudinal ligament or having longer operative segments than 3 vertebrae were significant risk factors for CSFL (p<0.05). Besides, surgeries on the mid-thoracic spine had an increased risk of CSFL (p<0.05).
  
  
  CONCLUSIONS
  From our analysis, CSFL was a common complication after thoracic decompression with the incidence of up to 32.3%. This study identified the predisposing clinical factors, and spinal surgeons should be aware of these risk factors to reduce its incidence.
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Panpan
authors.initials: P
authors.lastname: Hu
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Miao
authors.initials: M
authors.lastname: Yu
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Zhongjun
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wei
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Zhongqiang
authors.initials: Z
authors.lastname: Chen
keywords: Cerebrospinal fluid leakage; Incidence; Risk factors; Thoracic decompression