Objective: This study aims to identify risk factors associated with cerebrospinal fluid (CSF) leakage in patients undergoing spinal tumor surgery, thereby providing a basis for strategies to reduce its incidence. Methods: A total of 181 patients who underwent posterior open-separation surgery for spinal tumor at our institution between January 2024 and January 2025. Patients were categorized into an observation group (n = 19, with CSF leakage) and a control group (n = 162, without CSF leakage). Eighteen variables were compared between the groups, including age, sex, body mass index (BMI), history of diabetes, history of hypertension, smoking history, alcohol consumption history, prior radiotherapy, prior chemotherapy, postoperative constipation (within 72 hours), surgical site, disease duration, reoperation at the same spinal segment, number of decompression segments, tumor diameter, tumor adhesion to the dura mater, operative time, and intraoperative blood loss [1]-[3]. Results: postoperative constipation (within 72 hours), reoperation at the same spinal segment, and tumor adhesion to the dura mater were identified as significant risk factors for CSF leakage (P < 0.05), whereas age, sex, BMI, history of diabetes, history of hypertension, smoking history, alcohol consumption history, prior radiotherapy or chemotherapy, surgical site, disease duration, number of decompression segments, tumor diameter, operative time, and intraoperative blood loss were not significantly associated with CSF leakage (P > 0.05). Multivariate logistic regression analysis confirmed that postoperative constipation (within 72 hours), reoperation at the same spinal segment, and tumor adhesion to the dura mater were independent risk factors for CSF leakage (P < 0.05). Conclusion: postoperative constipation (within 72 hours), reoperation at the same spinal segment, and tumor adhesion to the dura mater are significant risk factors for CSF leakage following spinal tumor surgery. Comprehensive preoperative assessment and consideration of these factors in surgical planning are essential to minimize the risk of CSF leakage.
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