Deep venous thrombosis after lumbar disc surgery due to compression of the vena cava caused by a retroperitoneal haematoma.
The case of a 46-year-old Arabian male complaining of low back pain due to congenital lumbar spinal canal stenosis with additional disc herniation is presented. Following CT scan and MRI, bilateral enlarged partial hemilaminectomy was performed in L5/S1 with removal of herniated disc material. Intraoperatively, no complication was encountered. In the postoperative course, the patient had persistent low back pain and developed deep venous thrombosis in the left leg. Phlebography revealed thrombosis in the deep veins of the left leg extending into the pelvic region. The source of this high obstruction of the venous outflow was a retroperitoneal haematoma, visible on CT scan, compressing the vena cava at the level of L5/S1, the most probable cause of which was accidental perforation of the anterior spinal ligament. This case demonstrates that injury to the retroperitoneal vessels during lumbar disc surgery can also present as deep venous thrombosis due to obstruction of venous outflow.
Pechlivanis
I
I
Department of Neurosurgery, Ruhr-University of Bochum, Knappschaftskrankenhaus, In der Schornau 23-25, 44892, Bochum, Germany. ioannis.pechlivanis@rub.de
Engelhardt
M
M
Scholz
M
M
Harders
A
A
Schmieder
K
K
D017586:Diskectomy / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000473:pathology; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007431:Intraoperative Complications / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D007866:Leg / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D017846:Longitudinal Ligaments / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D017116:Low Back Pain / Q000209:etiology / Q000473:pathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D012187:Retroperitoneal Space / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D013130:Spinal Stenosis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D020246:Venous Thrombosis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology