Treatment of a retroperitoneal lymphocele after lumbar fusion surgery with intralesional povidone iodine: technical case report.
OBJECTIVE
This case report illustrates an uncommon complication from the retroperitoneal exposure of the lumbar spine. The diagnosis and management of a retroperitoneal lymphocele is presented. The lymphocele was treated with intralesional povidone iodine (Betadine; Purdue-Frederick, Norwalk, CT), which eradicated the lesion and provided symptomatic relief to the patient.


METHODS
A young woman developed an iatrogenic, rapidly progressive spondylolisthesis after having undergone three previous lumbar surgeries for radiculopathy at the L5-S1 level.


METHODS
A back-front-back approach was used for operative reduction and fusion of the spondylolisthesis. The patient's postoperative course was complicated by a retroperitoneal lymphocele. She presented with symptoms of urinary urgency and incontinence. The lymphocele was successfully treated with repeated drainage and sclerosis with povidone iodine. The patient ultimately developed a solid fusion, and her pain resolved.


CONCLUSIONS
A retroperitoneal lymphocele is an uncommon complication caused by the surgical exposure of the lumbar spine when a ventral approach is used. In this case, it was diagnosed and treated without further surgical intervention.
Levi
A D
AD
Department of Neurological Surgery, University of Miami School of Medicine, Florida 33136, USA.
D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008159:Lumbar Vertebrae / Q000601:surgery*; D008210:Lymphocele / Q000188:drug therapy* / Q000209:etiology*; D011183:Postoperative Complications; D011206:Povidone-Iodine / Q000008:administration & dosage / Q000627:therapeutic use*; D012187:Retroperitoneal Space; D013123:Spinal Fusion
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine