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Treatment of a retroperitoneal lymphocele after lumbar fusion surgery with intralesional povidone iodine: technical case report.

AbstractOBJECTIVE AND IMPORTANCE:
This case report illustrates an uncommon complication from the retroperitoneal exposure of the lumbar spine. The diagnosis and management of a retroperitoneal lymphocele is presented. The lymphocele was treated with intralesional povidone iodine (Betadine; Purdue-Frederick, Norwalk, CT), which eradicated the lesion and provided symptomatic relief to the patient.
CLINICAL PRESENTATION:
A young woman developed an iatrogenic, rapidly progressive spondylolisthesis after having undergone three previous lumbar surgeries for radiculopathy at the L5-S1 level.
INTERVENTION:
A back-front-back approach was used for operative reduction and fusion of the spondylolisthesis. The patient's postoperative course was complicated by a retroperitoneal lymphocele. She presented with symptoms of urinary urgency and incontinence. The lymphocele was successfully treated with repeated drainage and sclerosis with povidone iodine. The patient ultimately developed a solid fusion, and her pain resolved.
CONCLUSION:
A retroperitoneal lymphocele is an uncommon complication caused by the surgical exposure of the lumbar spine when a ventral approach is used. In this case, it was diagnosed and treated without further surgical intervention.
AuthorsA D Levi
JournalNeurosurgery (Neurosurgery) Vol. 45 Issue 3 Pg. 658-60; discussion 660-1 (Sep 1999) ISSN: 0148-396X [Print] United States
PMID10493389 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Anti-Infective Agents, Local
  • Povidone-Iodine
Topics
  • Adult
  • Anti-Infective Agents, Local (administration & dosage, therapeutic use)
  • Female
  • Humans
  • Iatrogenic Disease
  • Lumbar Vertebrae (surgery)
  • Lymphocele (drug therapy, etiology)
  • Postoperative Complications
  • Povidone-Iodine (administration & dosage, therapeutic use)
  • Retroperitoneal Space
  • Spinal Fusion

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