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

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Partheni, M.
Kalogheropoulou, C.
Karageorgos, N.
Panagiotopoulos, V.
Voulgaris, S.
Tzortzidis, F.

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peer-reviewed

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Spine J

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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.

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

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http://www.ncbi.nlm.nih.gov/pubmed/16825055
http://ac.els-cdn.com/S1529943005010648/1-s2.0-S1529943005010648-main.pdf?_tid=51162b5c9ad4ee86dcb51e6d9908769e&acdnat=1332758465_6d4d1c56f3387c544018f7dacded318e

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en

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Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής

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