STUDY DESIGN: Observational study of a case with a rare complication of lower limb compartment syndrome following total lumbar disc replacement via anterior retroperitoneal approach. OBJECTIVE: To describe a patient with lower limb compartment syndrome, following total lumbar disc replacement via anterior retroperitoneal approach. SUMMARY OF BACKGROUND DATA: Compartment syndrome is a rare complication of spinal surgery. Previously, there were very few reported cases of compartment syndrome following posterior approach through a knee chest position. We are reporting the first case of lower limb compartment syndrome following total lumbar disc replacement through anterior retroperitoneal approach. METHODS: Case report and literature review. RESULT: Total lumbar disc replacement through anterior retroperitoneal approach led to a vascular complication (left iliac vein injury) with failed attempt at surgical repair. At 48 hours, the patient developed left lower limb compartment syndrome. Surgical decompression of the compartment prevented serious sequel with a successful outcome. CONCLUSION: Total disc replacement in the lumbar spine complicated with an acute compartment syndrome due to the left common iliac vein injury is reported for the first time. A vigilant postoperative work-up in an unconscious patient resulted in the diagnosis and decompression with a successful outcome.
STUDY DESIGN: Observational study of a case with a rare complication of lower limb compartment syndrome following total lumbar disc replacement via anterior retroperitoneal approach. OBJECTIVE: To describe a patient with lower limb compartment syndrome, following total lumbar disc replacement via anterior retroperitoneal approach. SUMMARY OF BACKGROUND DATA: Compartment syndrome is a rare complication of spinal surgery. Previously, there were very few reported cases of compartment syndrome following posterior approach through a knee chest position. We are reporting the first case of lower limb compartment syndrome following total lumbar disc replacement through anterior retroperitoneal approach. METHODS: Case report and literature review. RESULT: Total lumbar disc replacement through anterior retroperitoneal approach led to a vascular complication (left iliac vein injury) with failed attempt at surgical repair. At 48 hours, the patient developed left lower limb compartment syndrome. Surgical decompression of the compartment prevented serious sequel with a successful outcome. CONCLUSION: Total disc replacement in the lumbar spine complicated with an acute compartment syndrome due to the left common iliac vein injury is reported for the first time. A vigilant postoperative work-up in an unconscious patient resulted in the diagnosis and decompression with a successful outcome.
Authors: Kiran G Divani; Andrew O'Brien; Sean Molloy; Jayesh Trivedi; Joseph Cowan; Alexander Gibson Journal: Eur Spine J Date: 2015-06-11 Impact factor: 3.134