Urinary bladder dysfunction following anterior lumbosacral spine fusion: case report and review of the literature.
A 34-year-old woman suffering from chronic degenerative low back pain involving L5-S1 disc space, refractory to conservative treatment, underwent spinal fusion. A combined instrumented posterolateral, followed by anterior, interbody allograft fusion through a left retroperitoneal approach was performed. Postoperatively, the patient was unable to evacuate her bladder and control her micturition. Anal tone and sensation were intact. A self-catheterisation regime was instituted with a diagnosis of parasympathetic nerve injury during the anterior spinal fusion. After a period of 3 months, the patient regained control of urination. We report this case to highlight the importance of protecting the parasympathetic presacral nerve during L5-S1 anterior interbody fusion, as injury to this nerve affects urinary evacuation.
Faraj
A A
AA
Centre of Spinal Studies and Surgery, University Hospital, Nottingham, Nottinghamshire, UK.
Webb
J K
JK
Lemberger
R J
RJ
D000328:Adult; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D010275:Parasympathetic Nervous System / Q000293:injuries*; D012447:Sacrum / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D014555:Urination Disorders / Q000209:etiology*