A rare postoperative complication of anterior lower thoracic instrumentation: diaphragmatic laceration with hemothorax.
Eur Spine J
; 26(Suppl 1): 146-150, 2017 05.
Article
em En
| MEDLINE
| ID: mdl-28035466
ABSTRACT
PURPOSE:
To highlight the importance of preventing visceral injury due to prominent anterior implants at the spinal column.METHODS:
A 52-year-old man with cord compression was treated with a T9/10 discectomy and instrumented fusion via a right thoracotomy and trans-pleural approach. Postoperatively, he had improved lower limb numbness. However, after a bout of coughing, there was sudden increase in chest drain output, hemodynamic instability and massive fluid collection in the right chest cavity.RESULTS:
Emergency re-exploration of the thoracotomy was performed and a 6 cm laceration of the right postero-medial diaphragm was identified as the bleeding source and was found to be in close proximity with the locking nut of the anterior implants. The laceration was repaired and a soft synthetic patch was used to cover the implants. Postoperatively, the hemothorax resolved and the patient recovered from the neurological deficit.CONCLUSIONS:
Prevention of diaphragmatic injury can be performed using lower profile and less sharp-edged implants. Implant coverage with a soft synthetic material is necessary if unable to perform direct repair of the parietal pleura over the implants.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Compressão da Medula Espinal
/
Fusão Vertebral
/
Diafragma
/
Discotomia
/
Lacerações
/
Hemotórax
/
Deslocamento do Disco Intervertebral
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
Limite:
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Eur Spine J
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
China