Insidious intraoperative ureteral damage as a complication in indirect lumbar interbody fusion surgical procedure: a case report.
BMC Res Notes. 2017 Jun 06;10(1):193
Authors: Kubota G, Orita S, Umimura T, Takahashi Okay, Ohtori S
BACKGROUND: Indirect lumbar interbody fusion surgical procedure is a not too long ago launched minimally invasive lateral interbody fusion surgical procedure for degenerative lumbar illness. There have been no experiences of related ureteral damage.
CASE PRESENTATION: A 77-year-old Japanese girl underwent indirect lumbar interbody fusion surgical procedure for lumbar spondylolisthesis with refractory low again ache and ache in each legs. The affected person skilled stomach ache 2 days after surgical procedure. Delayed contrast-enhanced computed tomography and retrograde urography revealed leakage of contrasted urine from the ureter into the retroperitoneal house, indicating a ureteral damage. Quick percutaneous nephrostomy was carried out to get better her situation, adopted by extra ureteral stenting. She is now free from preoperative signs however requires periodic altering of the ureteral stent, with no urinary signs.
CONCLUSION: The present report described a uncommon however attainable case of ureteral damage following indirect lumbar interbody fusion surgical procedure. Iatrogenic ureteral damage, as reported within the present case, is rare following indirect lumbar interbody fusion surgical procedure, and the damage might have been attributable to a procedural error. Contemplating the findings from urological examinations, we speculate that the thread pin that fixates the retractor injured the ureter throughout its set up. This case highlights the significance of cautious consideration whereas exposing the retroperitoneal house to keep away from minor organs, together with the ureters, in addition to main organs. Ureteral accidents ought to ideally be detected and recognized as quickly as attainable by cautious bodily and radiological examinations, similar to with delayed contrast-enhanced computed tomography and retrograde urography, to salvage the injured nephroureteral system. The present report additionally highlights that cautious use of surgical devices is essential for stopping intraoperative problems, together with ureteral damage.
PMID: 28587633 [PubMed – indexed for MEDLINE]