title: Radiculopathy after lumbar discectomy due to intraspinal retained Surgicel: clinical and magnetic resonance imaging evaluation.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Neurosurgery, University Hospital of Patras, 26500, Greece.
authors.forename: Melpomeni
authors.initials: M
authors.lastname: Partheni
authors.forename: Christina
authors.initials: C
authors.lastname: Kalogheropoulou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Karageorgos
authors.forename: Vasilios
authors.initials: V
authors.lastname: Panagiotopoulos
authors.forename: Spyridon
authors.initials: S
authors.lastname: Voulgaris
authors.forename: Fotios
authors.initials: F
authors.lastname: Tzortzidis
mesh_terms: D000328:Adult; D017586:Diskectomy / Q000009:adverse effects*; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications; D011843:Radiculopathy / Q000209:etiology* / Q000473:pathology