Radiculopathy after lumbar discectomy due to intraspinal retained Surgicel: clinical and magnetic resonance imaging evaluation

Spine J. 2006 Jul-Aug;6(4):455-8. doi: 10.1016/j.spinee.2005.12.006.

Abstract

Background context: Lumbar radiculopathy after lumbar spine surgery is an alerting sign usually caused by either a recurrent disc herniation or epidural hematoma. However, pressure on a spinal nerve root may also be exerted by a retained piece of Surgicel used to achieve hemostasis during lumbar spine surgical procedures.

Purpose: To describe a case of lumbar radiculopathy that was caused by a piece of Surgicel left in the spinal canal after operation for lumbar disc herniation.

Study setting: A case report of a retained piece of Surgicel being the cause of S1 radiculopathy.

Methods: Patient interview, medical records, imaging studies, and literature review.

Results: A 29-year-old man developed acute left S1 radiculopathy after a successful hemilaminectomy and discectomy operation for a L5-S1 disc herniation. In the magnetic resonance imaging studies that were performed, a postoperative hematoma could not be excluded and a reoperation revealed compression from Surgicel that was used for hemostasis. The patient was free of symptoms after reoperation.

Conclusions: This case depicts the difficulty in distinguishing-by means of magnetic resonance imaging-nerve root compression caused by a postoperative hematoma and a recurrent disc herniation, from that caused by a retained Surgicel. Therefore, hemostatic agents should be meticulously used in spine surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diskectomy / adverse effects*
  • Humans
  • Lumbar Vertebrae / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Postoperative Complications
  • Radiculopathy / etiology*
  • Radiculopathy / pathology