J Korean Orthop Assoc.  2009 Feb;44(1):141-144. 10.4055/jkoa.2009.44.1.141.

Textiloma Ten Years after a Lumbar Discectomy: A Case Report

• Cho JL
• Park YS
• Baek SW
• Kang CN

• KMID: 2186390
• DOI: http://doi.org/10.4055/jkoa.2009.44.1.141

Abstract

A paraspinal foreign body reaction is a rare condition that can cause severe neurological complications or death. However, the condition is often neglected. The authors report a case of a paraspinal textiloma that was diagnosed and treated with a surgical excision.

Keyword

Textiloma (gossypibomas); Foreign body granuloma; Lumbar discectomy

MeSH Terms

Foreign-Body Reaction
Granuloma, Foreign-Body

Figure

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  Fig. 1 (A) Sagittal T1-weighted MR image shows hypointense ellipsoid lesion with a central hypointense nidus in the left paravertebral soft tissue at the level of L4-5. (B) Sagittal T2-weighted MR image with contrast medium demonstrating a ring-enhanced, showing the lesion as hyperintense. (C) Axial T1-weighted MR image shows hypointense ellipsoid lesion.

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  Fig. 2 The excised specimen is measured 4.2×3.2×2.4 cm in size.

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  Fig. 3 The excised speciment is cutted. A retained sponge material was found within the paraspinal mass.

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  Fig. 4 Histologic findings (H-E staining). Submitted is a grayish white partially calcified fat tissue. Foreign body (Gauze) granuloma (×200, H-E stain).

Reference

1. Fariña LA, Villavicencio H, Chechile G. Preoperatively recognized chronically retained pararenal gauzoma. Int Urol Nephrol. 1995. 27:33–35.

2. Ford LT. Complications of lumbar-disc surgery, prevention and treatment. Local complications. J Bone Joint Surg Am. 1968. 50:418–428.

3. Gifford RR, Plaut MR, Mcleary RD. Retained surgical sponge following laminectomy. JAMA. 1973. 223:1040.

4. Marquardt G, Retting J, Lang J, Seifert V. Retained surgical sponges, a denied neurosurgical reality? Cautionary note. Neurosurg Rev. 2001. 24:41–43.

5. Massie JB, Heller JG, Abitbol JJ, McPherson D, Garfin SR. Postoperative posterior spinal wound infections. Clin Orthop Relat Res. 1992. 284:99–108.

6. Matsuki M, Matsuo M, Okada N. Case report: MR findings of a retained surgical sponge. Radial Med. 1998. 16:65–67.

7. Nabors MW, McCrary ME, Clemente RJ, et al. Identification of a retained surgical sponge using magnetic resonance imaging. Neurosurgery. 1986. 18:496–498.

8. Okten AI, Adam M, Gezercan Y. Textiloma: a case of foreign body mimicking a spinal mass. Eur Spine J. 2006. 15:Suppl 5. S626–S629.

9. Ramirez LF, Thisted R. Complications and demographic characteristics of patients undergoing lumbar discectomy in community hospitals. Neurosurgery. 1989. 25:226–231.

10. Turgut M, Akyuz O, Ozsunar Y, Kacar F. Sponge-induced granuloma ("gauzoma") as a complication of posterior lumbar surgery. Neurol Med Chir (Tokyo). 2005. 45:209–211.