Edward Fomekong1, Julien Pierrard2, Etienne Danse3, Bertrand Tombal4, Christian Raftopoulos5. 1. Department of Neurosurgery, Cliniques Universitaires Saint-Luc Bruxelles, Brussels, Belgium. 2. Department of Urology, Cliniques Universitaires Saint-Luc Bruxelles, Brussels, Belgium. 3. Department of Radiology, Cliniques Universitaires Saint-Luc Bruxelles, Brussels, Belgium. 4. Medical Student (MS), Université Catholique de Louvain, Brussels, Belgium. 5. Department of Neurosurgery, Cliniques Universitaires Saint-Luc Bruxelles, Brussels, Belgium. Electronic address: christian.raftopoulos@uclouvain.be.
Abstract
BACKGROUND: Injury of the ureter is a potentially devastating complication most often reported in gynecologic, colorectal, or vascular pelvic surgery or endoscopic procedures for ureteric diseases. We report a rare case of ureteral rupture occurring as a complication of percutaneous pedicle screw placement. CASE DESCRIPTION: A 60-year-old man reported unbearable abdominal pain on the day after right L4-L5 transforaminal intervertebral fusion and percutaneous pedicle screw placement. A computer tomography workup showed contrast media extravasation outside the excretory system consistent with a left ureteral traumatic perforation. The patient underwent left nephrostomy and a double-J stent insertion and subsequently fully recovered. The ureter completely healed, enabling stent removal 5 months later. METHODS: PubMed and EMBASE were screened for ureteral injury caused by posterior lumbar surgery. RESULTS: We found 27 other reports with only 1 other case after minimally invasive transforaminal lumbar interbody. CONCLUSIONS: Complications of minimally invasive pedicle screw placement are often described as dural tear of neurologic impairment. This report shows that unexpected side effects are still possible and spine surgeons should be aware especially when performing minimally invasive procedures, in which, by definition, pedicles are concealed from direct visualization.
BACKGROUND:Injury of the ureter is a potentially devastating complication most often reported in gynecologic, colorectal, or vascular pelvic surgery or endoscopic procedures for ureteric diseases. We report a rare case of ureteral rupture occurring as a complication of percutaneous pedicle screw placement. CASE DESCRIPTION: A 60-year-old man reported unbearable abdominal pain on the day after right L4-L5 transforaminal intervertebral fusion and percutaneous pedicle screw placement. A computer tomography workup showed contrast media extravasation outside the excretory system consistent with a left ureteral traumatic perforation. The patient underwent left nephrostomy and a double-J stent insertion and subsequently fully recovered. The ureter completely healed, enabling stent removal 5 months later. METHODS: PubMed and EMBASE were screened for ureteral injury caused by posterior lumbar surgery. RESULTS: We found 27 other reports with only 1 other case after minimally invasive transforaminal lumbar interbody. CONCLUSIONS: Complications of minimally invasive pedicle screw placement are often described as dural tear of neurologic impairment. This report shows that unexpected side effects are still possible and spine surgeons should be aware especially when performing minimally invasive procedures, in which, by definition, pedicles are concealed from direct visualization.
Authors: Chang Hwa Hong; Ki Jin Jung; Jae Wan Soh; Sung Hun Won; Si John Hong; Chang Hyun Kim; Hong Seop Lee; Soon Do Wang; Won Seok Lee; Woo Jong Kim Journal: Medicine (Baltimore) Date: 2019-02 Impact factor: 1.889
Authors: Franziska A Schmidt; Hervé M Lekuya; Sertac Kirnaz; Robert Nick Hernandez; Ibrahim Hussain; Louis Chang; Rodrigo Navarro-Ramirez; Christoph Wipplinger; Cameron Rawanduzy; Roger Härtl Journal: Global Spine J Date: 2021-01-12