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Lymphocoele: a rare and little known complication of anterior lumbar surgery

Schizas, Constantin ; Foko'o, Noël ; Matter, Maurice ; Romy, Sebastien ; Munting, Everard

In: European Spine Journal, 2009, vol. 18, p. 228-231

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    Title
    • Lymphocoele: a rare and little known complication of anterior lumbar surgery
    Author
    • Schizas, Constantin. Hôpital Orthopédique de la Suisse Romande, Centre Hospitalier Universitaire Vaudois, The University of Lausanne, Avenue Pierre-Decker 4, 1011, Lausanne, Switzerland
    • Foko'o, Noël. Orthopaedic Department, Clinique St-Pierre, Ottignies, Belgium
    • Matter, Maurice. Department of General Surgery, Centre Hospitalier Universitaire Vaudois, The University of Lausanne, Lausanne, Switzerland
    • Romy, Sebastien. Department of General Surgery, Centre Hospitalier Universitaire Vaudois, The University of Lausanne, Lausanne, Switzerland
    • Munting, Everard. Orthopaedic Department, Clinique St-Pierre, Ottignies, Belgium
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:314966
    Summary
    Lymphocoele is a rare and little known complication with only a handful of reports available. We report two cases of lymphocoele after anterior lumbar surgery that have occurred in two different centres and discuss diagnosis and management options. The first case is that of a 53-year-old male patient undergoing two level anterior lumbar interbody fusion (ALIF) for disabling back pain due to disc degeneration in the context of an old spondylodiscitis. He developed a large fluid mass postoperatively. Fluid levels of creatinin were low and intravenous urography ruled out a urinoma suggesting the diagnosis of a lymphocoele. Following two unsuccessful drainage attempts he underwent a laparoscopic marsupialization. The second case was that of a 32-year-old female patient developing a large fluid mass following a L5 corpectomy for a burst fracture. She was treated successfully with insertion of a vacuum drain during 7days. Lymphocoele is a rare complication but should be suspected if fluid collects postoperatively following anterior lumbar spine procedures. Chemical analysis of the fluid can help in diagnosis. Modern treatment consists of laparoscopic marsupialization. Lymph vessel anatomy should be borne in mind while exposing the anterior lumbar spine