Ureteral Injury Associated with Anterior Lumbosacral Arthrodesis in a Patient Who Had Crossed Renal Ectopia, Malrotation, and Fusion of the Kidneys. A Case Report*

Wymenga, L. F. A.; Buijs, Guido; Ypma, A.F.G.V.M.; Werkman, Dirk M

doi:10.2106/00004623-199605000-00018

Cited by 10 publications

(9 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…108,109 There have been numerous descriptions of ureteral injury secondary to anterior lumbar spine exposure. 46,64,96,103,109,110 Although the exact incidence of the complication is uncertain, in larger reported series 46,64,103 of anterior exposures, it ranged from 0.3% to 8.0%. Like arterial thromboses, retraction as well as division may cause ureteral disruption.…”

Section: Complications Of Anterior Lumbar Spine Exposurementioning

confidence: 99%

Methods and Complications of Anterior Exposure of the Thoracic and Lumbar Spine

Ikard¹

2006

Arch Surg

131

View full text Add to dashboard Cite

To review the methods and complications of exposing the anterior aspects of the thoracic and lumbosacral spine. Data Sources: PubMed (journals database of the National Library of Medicine), text books, the University HealthSystem Consortium Clinical Process Improvement Benchmarking Project, a newspaper, and the US government Healthcare Cost and Utilization Project. Study Selection: Descriptions of morbidity and mortality specifically related to anterior spine exposure depicted in both case reports and clinical series were used. Data Extraction: Mortality data from clinical series with more than 30 cases were tabulated. Morbidity incidences were described. Data Synthesis: The frequency of anterior exposure of the spine for structural operations is steadily increasing. Both thoracic and lumbosacral anterior spine operations are associated with exposure-related complication rates of 10% to 50%. Pulmonary complications are frequent after thoracic exposures. Chylothorax is the most common of several rarer chest-exposure complications. Vascular complications, particularly arterial thrombosis (Ͻ1% of cases) and venous bleeding (2%-15% of cases), are the most frequent complications at the lumbar level. Other lumbosacral exposure complications include ureteral and nerve (somatic and sympathetic) injury. The mortality rate in anterior spine exposures is less than 1%. Conclusions: The exposure portions of anterior spine operations result in numerous complications. There are fewer reported complications with endoscopic exposures of the anterior spine than with open exposures, although endoscopic exposures have been used for less complicated cases. In comparable cases, neither exposure nor results of endoscopic operations have proven better than operations done through minilaparotomy incisions. Perioperative cooperation between exposing and spine surgeons is necessary to enhance results in anterior spine operations.

show abstract

Section: Complications Of Anterior Lumbar Spine Exposurementioning

confidence: 99%

Methods and Complications of Anterior Exposure of the Thoracic and Lumbar Spine

Ikard¹

2006

Arch Surg

131

View full text Add to dashboard Cite

show abstract

“…1 Only a few cases of ureteral injury during anterior lumbar approach have been reported; all were recognized after 48 hours and managed using endoscopic and percutaneous techniques. [6][7][8][9] Other predisposing factors for ureteral injury after lumbar disk surgery include thin patients, patients with defects in or absence of the anterior annulus, retroperitoneal scars or adhesions or accidental perforation of the anterior longitudinal ligament.…”

Section: Discussionmentioning

confidence: 99%

Hand-assisted laparoscopic ureteroureterostomy with renal mobilization for delayed recognition of a proximal ureteral injury after lumbar disk surgery

Kaffenberger

Tomaszewski

Tsao

et al. 2013

CUAJ

View full text Add to dashboard Cite

We present hand-assisted laparoscopic ureteroureterostomy (HALUU) with renal mobilization as a novel approach to the management of proximal ureteral injury after lumbar disk surgery. A 63-year-old female underwent L4-L5 diskectomy and facetectomy with cage placement for back and leg pain. Postoperatively, she developed fever, nausea, abdominal pain, ileus and leukocytosis. A computed tomography scan of the abdomen and pelvis with intravenous contrast and delayed imaging demonstrated a left proximal ureteral injury with contrast extravasation. Retrograde and antegrade ureteral stent placement was unsuccessful; a nephrostomy tube was placed. Antegrade and retrograde ureterograms revealed a 3-cm proximal ureteral defect. All treatment options were discussed, and the patient chose to undergo hand-assisted laparoscopic renal mobilization with ureteroureterostomy, which was completed successfully without complications. Operative time was 381 minutes; estimated blood loss was 50 mL. The patient was discharged after 2 days, her ureteral stent was removed in 8 weeks, and follow-up with furosemide-mercaptoacetyltriglycine (MAG-3) renal scan demonstrated 30% function without evidence of obstruction. Hand-assisted laparoscopic ureteroureterostomy with renal mobilization can be performed as definitive management of a medium-length proximal ureteral injury. This is the first case describing this management technique after lumbar disk surgery.Can Urol Assoc J 2010;4(3):E82-E85

show abstract

“…Spinal surgery may very rarely cause such injury. 4,7 A ureteral injury incurred during surgery often is not suspected clinically because symptoms and signs are usually nonspecific, including abdominal pain, fever, vomiting, leukocytosis, and a tender, distended abdomen. The diagnosis is therefore often made with considerable delay, and imaging is necessary to demonstrate the pathology.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 In the third patient, the urinoma was proved on immediate exploration after the CT, which had shown a large waterdensity fluid collection. 7 The presence of ascites or localized fluid collections in the left retroperitoneum of symptomatic patients after spinal surgery should raise the possibility of a ureteral injury. A high index of suspicion is essential, and a CT study with delayed scanning should be performed to establish the diagnosis of ureteral injury causing a urinoma.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Perirectal Urinoma From Ureteral Injury Incurred During Spinal Surgery Mimicking Rectal Perforation On Computed Tomography Scan

Gayer¹,

Caspi²,

Garniek³

et al. 2002

Spine

View full text Add to dashboard Cite

Although ureteral injury after abdominal surgery is not so uncommon, it is very rarely incurred during spinal surgery. Because symptoms are usually nonspecific, the radiologist should be aware of this possible complication, and should perform CT with intravenous contrast material and with delayed scans because a rapid-sequence helical CT may not yet show opacification of the fluid present in the abdomen. This is the hallmark of the diagnosis.

show abstract

Ureteral Injury Associated with Anterior Lumbosacral Arthrodesis in a Patient Who Had Crossed Renal Ectopia, Malrotation, and Fusion of the Kidneys. A Case Report*

Cited by 10 publications

References 4 publications

Methods and Complications of Anterior Exposure of the Thoracic and Lumbar Spine

Methods and Complications of Anterior Exposure of the Thoracic and Lumbar Spine

Hand-assisted laparoscopic ureteroureterostomy with renal mobilization for delayed recognition of a proximal ureteral injury after lumbar disk surgery

Perirectal Urinoma From Ureteral Injury Incurred During Spinal Surgery Mimicking Rectal Perforation On Computed Tomography Scan

Contact Info

Product

Resources

About