J Minim Invasive Spine Surg Tech.  2017 Jun;2(1):32-34. 10.21182/jmisst.2017.00199.

Huge Retroperitoneal Hematoma Following Oblique Lumbar Interbody Fusion

Affiliations
  • 1Department of Neurosurgery, Spine Center, Saeng Saeng Hospital, Bucheon, Korea
  • 2Department of Neurosurgery, Spine Center, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
  • 3Department of Neurosurgery, Spine Center, Suwon Wiltse Memorial Hospital, Suwon, Korea

Abstract

A 64-year-old man who had lumbar spinal stenosis underwent oblique lumbar interbody fusion (OLIF) with cortical screw fixation at the L2-3, L3-4, and L4-5 levels. During the operation, there was no event of serious surgical bleeding. After the operation, he complained of severe flank pain and back pain. A computerized tomography (CT) scan identified a huge amount of retroperitoneal hematoma compressing peritoneum and the patient underwent exploration immediately. There was active arterial bleeding at the drain puncture site. The active arterial bleeding was controlled and the retroperitoneal hematoma was removed. The patient’s symptoms were recovered after the second operation. A huge amount of retroperitoneal hematoma after OLIF requiring reoperation is rare. Meticulous bleeding control and repeated inspection of the drain puncture site are critical prior to wound closure. In addition, for patients presenting with severe pain after the operation, rapid evaluation using CT and second operation is required as soon as possible.

Keyword

Oblique lumbar interbody fusion; Retroperitoneal hematoma; Postoperative bleeding; Reoperation
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