An Unusual Case of Ureteral Perforation in Minimally Invasive Pedicle Screw Instrumentation: Case Report and Review of the Literature

Fomekong, Edward; Pierrard, Julien; Danse, Étienne; Tombal, Bertrand; Raftopoulos, Christian

doi:10.1016/j.wneu.2017.11.175

Cited by 8 publications

(5 citation statements)

References 43 publications

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“…Instrumentation: The use of pedicle screws was reported in all the studies included. It is important to mention that 11 studies 17,19,21,22,28,[30][31][32]34,35,37 refer to instrumentation with percutaneous pedicle screws and 12 18,20,23,24,[26][27][28][29]33,[36][37][38] refer to pedicle screws. Some of them specify other types of instrumentation used in conjunction with the screws: cage (6 studies), 20,21,28,[35][36][37] rod (1 study), 32 and percutaneous s2AI screws (1 study).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Minimally Invasive Lumbar Arthrodesis and Percutaneous Pedicle Screws: A Systematic Review

et al. 2020

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A systematic review of the literature was performed in order to organize, evaluate, and select evidences available about the safety and efficacy of minimally invasive percutaneous arthrodesis with percutaneous pedicle screws in the treatment of patients with degenerative disc disease (and other spinal pathologies) as compared to conventional arthrodesis. PubMed, EMBASE and Cochrane Library databases were consulted to locate clinical trials and case reports/case series published in English between 2014 and 2019. After selection according to the inclusion/exclusion criteria, 21 of the 197 articles identified were chosen for a complete reading and used for the present review. Although the level of evidence of most of the studies included made the demonstration of efficacy and superiority among the surgical techniques reviewed difficult, the findings related to the minimally invasive procedure indicate a safe and reliable approach for the treatment of lumbar diseases. Level of evidence II; Systematic review of literature.

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Section: Resultsmentioning

confidence: 99%

“…Of the 21 studies selected, 6 had VAS information (2 clinical trials 18,28 and 4 case reports 17,22,27,30 ) and 9 (2 clinical trials 18,28 and 7 case reports 17,20,22,27,30,34,36 ) had ODI information. Both clinical trials reported a mean value for the participants.…”

Section: Visual Analog Scale (Vas) and Oswestry Disability Index (Odi)mentioning

confidence: 99%

Minimally Invasive Lumbar Arthrodesis and Percutaneous Pedicle Screws: A Systematic Review

et al. 2020

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“…This can cause disruption in the workflow and also time consuming. [27][28][29][30][31][32][33] The primary downside of this system is that the sharpness of the stylet which can traumatize tissue when being docked initially or potentially cause injuries to surrounding structures if the screw placement deviates from ideal trajectory. Another downside is that since there are no intermediate steps, redirecting or replacing a screw after it has been placed in its initiate trajectory may be challenging because a screw tract has already been made.…”

Section: Discussionmentioning

confidence: 99%

Novel MIS 3D NAV Single Step Pedicle Screw System (SSPSS): Workflow, Accuracy and Initial Clinical Experience

Schmidt

Lekuya

Kırnaz

et al. 2021

Global Spine Journal

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Study Design: Prospective case series. Objective: SSPSS (single step pedicle screw system) was developed for minimally invasive spine surgery. We performed this study to report on safety, workflow, and our initial clinical experience with this novel technique. Methods: The prospective study was conducted on patients who underwent pedicle screw fixation between October 2017 and April 2018 using a novel single step 3D navigated pedicle screw system for MIS. Outcome measurements were obtained from intraoperative computerized tomography. The images were evaluated to determine pedicle wall penetration. We used a grading system to assess the severity of the pedicle wall penetration. Breaches were classified as grade 1 (<2 mm), grade 2 (2-4 mm), or grade 3 (<4 mm), 1 and as cranial, caudal, medial, and lateral. Results: Our study includes 135 screws in 24 patients. SSPSS eliminated K-wires and multiple steps traditionally necessary for MIS pedicle screw insertion. The median time per screw was 2.45 minutes. 3 screws were corrected intraoperatively. Pedicle wall penetration occurred in 14 screws (10%). Grade 1 breaches occurred in 4 screws (3%) and grade 2 breaches occurred in 10 screws (7%). Lateral breaches were observed more often than medial breaches. The accuracy rate in our study was 90% (Grade 0 breach). No revision surgeries were needed and no complications occurred. Conclusions: Our study suggests that SSPSS could be a safe, accurate, and efficient tool. Our accuracy rate is comparable to that found in the literature.

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“…It has been recommended that immediate recognition and repair of ureter convulsion allow for better results and fewer complications 2. In most cases of late diagnosis, the treatment usually started with percutaneous drainage 15. Patients usually suffered from flank pain or vomiting; a longer hospital stay would be required 3.…”

Section: Discussionmentioning

confidence: 99%

<p>Complete ureter avulsion causing a long defect as a complication of posterior spine fusion: a rare case treated with nonrobotic laparoscopic repair</p>

Lai¹,

Chang²,

Huang³

et al. 2019

RRU

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PurposeUreter avulsion, a challenging urologic complication, has been rarely found in lumbar spine surgeries. Once ignored, the leaked urine usually leads to significant morbidity and also makes further repair more difficult. We present an unusual ureter injury causing a long defect which occurred in posterior spine fusion; immediate repair was performed with minimal invasion.Case presentationA 61-year-old female was receiving microscopic spine fusion (transforaminal lumbar interbody fusion) for her L3–L5 spondylosis. Ureter avulsion with one 3-cm defect occurred unexpectedly. We confirmed urine extravasation promptly, and performed end-to-end ureteroureterostomy with laparoscopy. Retrograde double-J stenting was indwelled. Her postoperative condition was uneventful.ConclusionThis rare case with good outcome highlights the importance of early diagnosis and immediate repair for complete ureter avulsion. We prove that reanastomosis for ureter loss as much as 3 cm is feasible with laparoscopy in regional hospitals where a robot is not available. To deal with large gaps between stumps, adequate kidney mobilization is required before anastomosis.

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An Unusual Case of Ureteral Perforation in Minimally Invasive Pedicle Screw Instrumentation: Case Report and Review of the Literature

Cited by 8 publications

References 43 publications

Minimally Invasive Lumbar Arthrodesis and Percutaneous Pedicle Screws: A Systematic Review

Minimally Invasive Lumbar Arthrodesis and Percutaneous Pedicle Screws: A Systematic Review

Novel MIS 3D NAV Single Step Pedicle Screw System (SSPSS): Workflow, Accuracy and Initial Clinical Experience

<p>Complete ureter avulsion causing a long defect as a complication of posterior spine fusion: a rare case treated with nonrobotic laparoscopic repair</p>

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