Topping Phenomenon with Recurrent Spinal Stenosis and Epidural Fibrosis Prevented with Oxidized Cellulose - a Case Report.

Abstract

Lumbar spinal stenosis is a condition where the neural structures are compressed in the narrowed spinal canal and often situated only within a single specific segment of the spine, most frequently in the lumbar spine. A case report demonstrates a surgical solution of lumbar spinal stenosis with using oxidized cellulose as a prevention of post-operative adhesions and failed back syndrome. A female patient (68) with a significant pain of the lumbar spine lasting for a number of months due to advanced spondylosis, failing to respond to conservative treatment underwent instrumented, posterolateral fusion of affected segments. The patient re-arrived with pain due to spinal stenosis in another segments after 4 and then after 3 years. We repeatedly performed spinal fusion of the affected segments and applied an antiadhesive gel to the dural sac and the decompressed nerve roots to prevent the development of post-operative adhesions and the "failed back syndrome". Last surgical solution included mobilisation of the simultaneously constricted dural sac through laminectomy. This time we covered the sac using a haemostat made of oxidized cellulose (Traumacel FAM). After this treatment, the patient was again without significant difficulties.

• Authors: Radek Hart
• Journal: Acta medica (Hradec Kralove) (Acta Medica (Hradec Kralove)) 2018 Vol. 61 Issue 2 Pg. 69-73 ISSN: 1211-4286 [Print] Czech Republic
• PMID: 30216187 (Publication Type: Case Reports, Journal Article)

Chemical References

• Cellulose, Oxidized
• Hemostatics

Topics

• Aged
• Cellulose, Oxidized (therapeutic use)
• Female
• Hemostatics (therapeutic use)
• Humans
• Laminectomy
• Lumbar Vertebrae (surgery)
• Spinal Fusion
• Spinal Stenosis (surgery)