title: Spinal cord ischemia after post-chemotherapy retroperitoneal lymph node dissection for nonseminomatous germ cell cancer.
abstract: OBJECTIVE
  We report and analyze several cases of neurological deficit after post-chemotherapy retroperitoneal lymph node dissection that were though to be related to spinal cord ischemia.
  
  
  METHODS
  We searched the testis cancer data base at our university, which includes 1,447 retroperitoneal lymph node dissections performed from 1982 to 1994, to identify patients who had postoperative neurological complications. The history and clinical course of patients suspected to have spinal cord ischemia were reviewed and potential risk factors were analyzed.
  
  
  RESULTS
  The incidence of spinal cord ischemia after post-chemotherapy retroperitoneal lymph node dissection was 0.56% (4 of 712 patients).
  
  
  CONCLUSIONS
  Spinal cord ischemia may complicate the course of post-chemotherapy retroperitoneal lymph node dissection in testis cancer patients. Older age, extensive retroperitoneal dissection, prior therapy and certain anesthetic parameters may predispose nonseminomatous germ cell tumor patients to spinal cord ischemia. These risk factors may be used to define a subset of high risk patients, and active measures should be taken in an attempt to minimize the frequency of spinal cord ischemia in these patients.
authors.affiliation: Department of Urology, Indiana University Medical Center, Indianapolis, USA.
authors.forename: I
authors.initials: I
authors.lastname: Leibovitch
authors.forename: P A
authors.initials: PA
authors.lastname: Nash
authors.forename: J S
authors.initials: JS
authors.lastname: Little
authors.forename: R S
authors.initials: RS
authors.lastname: Foster
authors.forename: J P
authors.initials: JP
authors.lastname: Donohue
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D018237:Germinoma / Q000628:therapy*; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000209:etiology*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology*; D012187:Retroperitoneal Space; D013116:Spinal Cord / Q000098:blood supply*; D013736:Testicular Neoplasms / Q000628:therapy*