Insidious intraoperative ureteral injury as a complication in oblique lumbar interbody fusion surgery: a case report
Abstract Background Oblique lumbar interbody fusion surgery is a recently introduced minimally invasive lateral interbody fusion surgery for degenerative lumbar disease. There have been no reports of associated ureteral injury. Case presentation A 77-year-old Japanese woman underwent oblique lumbar...
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| Language: | English |
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BMC
2017-06-01
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| Series: | BMC Research Notes |
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| Online Access: | http://link.springer.com/article/10.1186/s13104-017-2509-9 |
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| author | Go Kubota Sumihisa Orita Tomotaka Umimura Kazuhisa Takahashi Seiji Ohtori |
| author_facet | Go Kubota Sumihisa Orita Tomotaka Umimura Kazuhisa Takahashi Seiji Ohtori |
| author_sort | Go Kubota |
| collection | DOAJ |
| description | Abstract Background Oblique lumbar interbody fusion surgery is a recently introduced minimally invasive lateral interbody fusion surgery for degenerative lumbar disease. There have been no reports of associated ureteral injury. Case presentation A 77-year-old Japanese woman underwent oblique lumbar interbody fusion surgery for lumbar spondylolisthesis with refractory low back pain and pain in both legs. The patient experienced abdominal pain 2 days after surgery. Delayed contrast-enhanced computed tomography and retrograde urography revealed leakage of contrasted urine from the ureter into the retroperitoneal space, indicating a ureteral injury. Immediate percutaneous nephrostomy was performed to recover her condition, followed by additional ureteral stenting. She is now free from preoperative symptoms but requires periodic changing of the ureteral stent, with no urinary symptoms. Conclusion The current report described a rare but possible case of ureteral injury following oblique lumbar interbody fusion surgery. Iatrogenic ureteral injury, as reported in the current case, is uncommon following oblique lumbar interbody fusion surgery, and the injury may have been caused by a procedural error. Considering the findings from urological examinations, we speculate that the thread pin that fixates the retractor injured the ureter during its installation. This case highlights the importance of careful attention while exposing the retroperitoneal space to avoid minor organs, including the ureters, as well as major organs. Ureteral injuries should ideally be detected and diagnosed as soon as possible by careful physical and radiological examinations, such as with delayed contrast-enhanced computed tomography and retrograde urography, to salvage the injured nephroureteral system. The current report also highlights that careful use of surgical instruments is key for preventing intraoperative complications, including ureteral injury. |
| first_indexed | 2024-12-10T09:26:13Z |
| format | Article |
| id | doaj.art-296e7fe52e5540f98867e12b4351b066 |
| institution | Directory Open Access Journal |
| issn | 1756-0500 |
| language | English |
| last_indexed | 2024-12-10T09:26:13Z |
| publishDate | 2017-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Research Notes |
| spelling | doaj.art-296e7fe52e5540f98867e12b4351b0662022-12-22T01:54:30ZengBMCBMC Research Notes1756-05002017-06-011011410.1186/s13104-017-2509-9Insidious intraoperative ureteral injury as a complication in oblique lumbar interbody fusion surgery: a case reportGo Kubota0Sumihisa Orita1Tomotaka Umimura2Kazuhisa Takahashi3Seiji Ohtori4Department of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba UniversityAbstract Background Oblique lumbar interbody fusion surgery is a recently introduced minimally invasive lateral interbody fusion surgery for degenerative lumbar disease. There have been no reports of associated ureteral injury. Case presentation A 77-year-old Japanese woman underwent oblique lumbar interbody fusion surgery for lumbar spondylolisthesis with refractory low back pain and pain in both legs. The patient experienced abdominal pain 2 days after surgery. Delayed contrast-enhanced computed tomography and retrograde urography revealed leakage of contrasted urine from the ureter into the retroperitoneal space, indicating a ureteral injury. Immediate percutaneous nephrostomy was performed to recover her condition, followed by additional ureteral stenting. She is now free from preoperative symptoms but requires periodic changing of the ureteral stent, with no urinary symptoms. Conclusion The current report described a rare but possible case of ureteral injury following oblique lumbar interbody fusion surgery. Iatrogenic ureteral injury, as reported in the current case, is uncommon following oblique lumbar interbody fusion surgery, and the injury may have been caused by a procedural error. Considering the findings from urological examinations, we speculate that the thread pin that fixates the retractor injured the ureter during its installation. This case highlights the importance of careful attention while exposing the retroperitoneal space to avoid minor organs, including the ureters, as well as major organs. Ureteral injuries should ideally be detected and diagnosed as soon as possible by careful physical and radiological examinations, such as with delayed contrast-enhanced computed tomography and retrograde urography, to salvage the injured nephroureteral system. The current report also highlights that careful use of surgical instruments is key for preventing intraoperative complications, including ureteral injury.http://link.springer.com/article/10.1186/s13104-017-2509-9Oblique lumbar interbody fusion (OLIF)Minimally invasive surgeryLumbar spineUreteral injuryComplicationsInterbody fusion |
| spellingShingle | Go Kubota Sumihisa Orita Tomotaka Umimura Kazuhisa Takahashi Seiji Ohtori Insidious intraoperative ureteral injury as a complication in oblique lumbar interbody fusion surgery: a case report BMC Research Notes Oblique lumbar interbody fusion (OLIF) Minimally invasive surgery Lumbar spine Ureteral injury Complications Interbody fusion |
| title | Insidious intraoperative ureteral injury as a complication in oblique lumbar interbody fusion surgery: a case report |
| title_full | Insidious intraoperative ureteral injury as a complication in oblique lumbar interbody fusion surgery: a case report |
| title_fullStr | Insidious intraoperative ureteral injury as a complication in oblique lumbar interbody fusion surgery: a case report |
| title_full_unstemmed | Insidious intraoperative ureteral injury as a complication in oblique lumbar interbody fusion surgery: a case report |
| title_short | Insidious intraoperative ureteral injury as a complication in oblique lumbar interbody fusion surgery: a case report |
| title_sort | insidious intraoperative ureteral injury as a complication in oblique lumbar interbody fusion surgery a case report |
| topic | Oblique lumbar interbody fusion (OLIF) Minimally invasive surgery Lumbar spine Ureteral injury Complications Interbody fusion |
| url | http://link.springer.com/article/10.1186/s13104-017-2509-9 |
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