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Cauda Equina Syndrome Caused by Intradural Bone Graft Materials After Endoscopic Lumbar Fusion
Orthopedics ( IF 1.1 ) Pub Date : 2022-09-07 , DOI: 10.3928/01477447-20220831-08
Fei Yang , Qingjie Li , Ying Liu , Dangwei Gu , Jianhua Qi , Kai Xu , Hong Ming , Xiaohong Fan , Rigao Chen

A 53-year-old man presented to the emergency department with severe lower back pain, saddle anesthesia, and urinary dysfunction. He had undergone endoscopic lumbar interbody fusion for highly migrated lumbar disk herniation and lumbar instability 10 days ago. Emergency computed tomography showed that the bone graft materials had migrated to the sacral canal, and a mass with low intensity was seen located at the end of the dural cavity on T2-weighted magnetic resonance imaging. It was suspected that the bone graft materials had migrated into the dural cavity at the operative level and fallen into the end of the dural cavity due to gravity, causing acute cauda equina syndrome (CES). After emergency durotomy, the bone graft materials were completely removed. At the 18-month follow-up, the patient recovered without further complications. This procedure resulted in a rare case of CES caused by intradural bone graft after endoscopic lumbar interbody fusion. Spine surgeons should be aware of this rare but potentially dangerous complication, especially in water-based endoscopic lumbar interbody fusion. This case report shows that early recognition and prompt treatment can significantly improve the symptoms of CES, including saddle numbness and bladder dysfunction. [Orthopedics. 20XX;XX(X):xx–xx.]



中文翻译:

内镜腰椎融合术后硬膜内植骨材料引起的马尾综合征

一名 53 岁男性因严重腰痛、鞍部麻醉和泌尿功能障碍而到急诊科就诊。10天前,他因高度迁移性腰椎间盘突出症、腰椎不稳定接受了内镜下腰椎椎间融合术。紧急CT显示植骨材料已迁移至骶管,T2加权磁共振成像在硬脑膜腔末端可见低强度肿块。怀疑植骨材料在术中已迁移至硬脑膜腔内,并因重力作用而落入硬脑膜腔末端,引起急性马尾综合征(CES)。紧急硬脑膜切开术后,骨移植材料被完全取出。在 18 个月的随访中,患者康复,没有出现进一步的并发症。该手术导致内镜下腰椎椎间融合术后硬膜内植骨引起的CES罕见病例。脊柱外科医生应该意识到这种罕见但潜在危险的并发症,特别是在水基内窥镜腰椎椎间融合术中。本病例报告表明,早期识别和及时治疗可以显着改善CES症状,包括鞍部麻木和膀胱功能障碍。[骨科。20XX;XX(X):xx–xx。]

更新日期:2022-09-07
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