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Retroperitoneal lymphocele after lumbar total disc replacement: a case report and review of literature

BACKGROUND: Retroperitoneal lymphoceles (RPLs) caused by injury to the lymphatics are commonly seen after pelvic lymphadenectomy, renal transplantation, and gynecologic tumor resection surgeries. Degenerative disc disease still remains the major cause of low-back pain. Anterior lumbar spinal procedu...

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Autores principales: Mohapatra, Bibhudendu, Kishen, Thomas, Loi, Ken W. K., Diwan, Ashish D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier, Inc. 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365637/
https://www.ncbi.nlm.nih.gov/pubmed/25802655
http://dx.doi.org/10.1016/j.esas.2010.01.006
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author Mohapatra, Bibhudendu
Kishen, Thomas
Loi, Ken W. K.
Diwan, Ashish D.
author_facet Mohapatra, Bibhudendu
Kishen, Thomas
Loi, Ken W. K.
Diwan, Ashish D.
author_sort Mohapatra, Bibhudendu
collection PubMed
description BACKGROUND: Retroperitoneal lymphoceles (RPLs) caused by injury to the lymphatics are commonly seen after pelvic lymphadenectomy, renal transplantation, and gynecologic tumor resection surgeries. Degenerative disc disease still remains the major cause of low-back pain. Anterior lumbar spinal procedures, such as anterior lumbar interbody fusion and anterior lumbar arthroplasty, have been increasingly performed for treatment of axial back pain. RPLs, as an approach-related complication, though infrequent, have been reported after anterior lumbar spinal surgery. We report a case of RPL after total disc replacement of the lumbar spine. To our knowledge, there has been no prior report of RPL after total disc replacement managed by percutaneous aspiration only. METHODS: A 49-year-old woman who underwent total disc replacement at the L4-5 level presented with a postoperative complication of RPL. The imaging findings, clinical course, and treatment are discussed, and a review of literature is presented. RESULTS: The patient presented with significant abdominal swelling and discomfort at 4 weeks after surgery without any signs or symptoms of infection. Investigations showed an RPL. She was treated by multiple aspirations under ultrasound guidance. At 12 months’ follow-up, the patient had no further abdominal symptoms and had gone back to her routine activities and work with significant improvement in back pain. CONCLUSIONS: RPL is an uncommon complication after anterior lumbar surgery and can be managed effectively if detected and diagnosed early. Although repeated aspiration is associated with high recurrence and infection, it is a safe and minimally invasive procedure to manage RPL.
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spelling pubmed-43656372015-03-23 Retroperitoneal lymphocele after lumbar total disc replacement: a case report and review of literature Mohapatra, Bibhudendu Kishen, Thomas Loi, Ken W. K. Diwan, Ashish D. SAS J Full Length Article BACKGROUND: Retroperitoneal lymphoceles (RPLs) caused by injury to the lymphatics are commonly seen after pelvic lymphadenectomy, renal transplantation, and gynecologic tumor resection surgeries. Degenerative disc disease still remains the major cause of low-back pain. Anterior lumbar spinal procedures, such as anterior lumbar interbody fusion and anterior lumbar arthroplasty, have been increasingly performed for treatment of axial back pain. RPLs, as an approach-related complication, though infrequent, have been reported after anterior lumbar spinal surgery. We report a case of RPL after total disc replacement of the lumbar spine. To our knowledge, there has been no prior report of RPL after total disc replacement managed by percutaneous aspiration only. METHODS: A 49-year-old woman who underwent total disc replacement at the L4-5 level presented with a postoperative complication of RPL. The imaging findings, clinical course, and treatment are discussed, and a review of literature is presented. RESULTS: The patient presented with significant abdominal swelling and discomfort at 4 weeks after surgery without any signs or symptoms of infection. Investigations showed an RPL. She was treated by multiple aspirations under ultrasound guidance. At 12 months’ follow-up, the patient had no further abdominal symptoms and had gone back to her routine activities and work with significant improvement in back pain. CONCLUSIONS: RPL is an uncommon complication after anterior lumbar surgery and can be managed effectively if detected and diagnosed early. Although repeated aspiration is associated with high recurrence and infection, it is a safe and minimally invasive procedure to manage RPL. Elsevier, Inc. 2010-09-01 /pmc/articles/PMC4365637/ /pubmed/25802655 http://dx.doi.org/10.1016/j.esas.2010.01.006 Text en © 2010 Published by Elsevier Inc. on behalf of SAS - The International Society for the Advancement of Spine Surgery. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Full Length Article
Mohapatra, Bibhudendu
Kishen, Thomas
Loi, Ken W. K.
Diwan, Ashish D.
Retroperitoneal lymphocele after lumbar total disc replacement: a case report and review of literature
title Retroperitoneal lymphocele after lumbar total disc replacement: a case report and review of literature
title_full Retroperitoneal lymphocele after lumbar total disc replacement: a case report and review of literature
title_fullStr Retroperitoneal lymphocele after lumbar total disc replacement: a case report and review of literature
title_full_unstemmed Retroperitoneal lymphocele after lumbar total disc replacement: a case report and review of literature
title_short Retroperitoneal lymphocele after lumbar total disc replacement: a case report and review of literature
title_sort retroperitoneal lymphocele after lumbar total disc replacement: a case report and review of literature
topic Full Length Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365637/
https://www.ncbi.nlm.nih.gov/pubmed/25802655
http://dx.doi.org/10.1016/j.esas.2010.01.006
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