Spondylodiscitis after lumbar disk surgery

The value of perioperative prophylactic use of antibiotics in lumbar disc surgery is investigated, based on a retrospective study of the operative results of 5041 patients. The rate of occurrence of postoperative spondylodiscitis was significantly higher during the period in which no perioperative prophylaxis was carried out, than it was during the period, in which perioperative prophylaxis was routine. Thus the perioperative prophylactic use of antibiotics seems highly recommendable.     

Ventriculitis after metrizamide lumbar myelography

A 62-year-old man underwent lumbar metrizamide myelography complicated initially by a bout of aseptic chemical meningitis. Afterward, he suffered persistent headache, nausea, and blurred vision and, 12 weeks after his myelography, computed tomographic scans showed abnormalities consistent with a chronic ventriculitis. The case is presented; its pathological substrate and clinical implications are discussed.     

Intravertebral pseudomeningocele: an unusual complication after disc surgery

Background contextPseudomeningoceles are most commonly the result of dural tear during spine surgery. They may sometimes slowly enlarge but they generally develop inside the spinal canal, toward the foramina or toward the surgical incision.PurposeTo describe a late and exceptional complication of a surgical discectomy.Study designA case report.MethodsWe report a unique case of a large asymptomatic pseudomeningocele strictly developed in the L5 vertebra, discovered incidentally in a 38-year-old woman. Computed tomography and magnetic resonance imaging showed a large cystic lesion involving the vertebral body and the left pedicle of L5 without contrast enhancement. There was neither extension of the cyst toward the vertebral lamina nor toward the spinal canal. Consent to publish the data was obtained from our patient.ResultsDiagnosis was performed during transpedicular image-guided puncture, when opacification of the cyst revealed dural communication. Biochemical analysis and cytology confirmed the presence of cerebrospinal fluid and absence of tumoral cells.ConclusionsDural tear was considered as a neglected complication after surgical discectomy at the same level performed 18 years ago. Differential diagnoses of cystic spinal lesions are discussed.     

Esophageal tear: an unusual complication after difficult endotracheal intubation

Esophageal perforation is a serious life threatening injury that may occur during inadvertent esophageal intubation. We report two cases of iatrogenic esophageal perforation after attempted endotracheal intubation. Our experience confirms that early diagnosis (as in the first case) is associated with a more favorable outcome. Therefore, a high index of suspicion is required for early diagnosis of this complication because the symptoms are often nonspecific and may be delayed.     

Tension pneumocephalus: an unusual complication after lung resection.

On day 5, after right upper lobectomy, the patient developed headache, confusion and right hemiparesis and there was clear fluid drainage from the chest tube. Computed tomography (CT) scan of the head showed gas in the ventricles and subarachnoid space. The fluid from the drain was positive for Beta-2 transferrin signifying cerebrospinal fluid (CSF) fistula. Patient recovered completely with conservative management.     

Voiding dysfunction after abdominoplasty—an unusual complication

Abdominoplasty is an electively undertaken aesthetic operation mostly performed on patients after massive weight reduction. Previous case reports have demonstrated an improvement of incontinence symptoms after abdominoplasty. We report a case where urinary dysfunction occurred after refashioning of an abdominoplasty. The stress urinary incontinence got worse but what was of greater concern to her was a noticeable change of her urinary stream in an upward direction. A urethrolysis combined with an insertion of a tension-free vaginal tape and an anterior colporrhaphy was performed. After the operation, stress urinary incontinence improved and she reported that her urine stream reverted towards a normal direction.     

Rhizolysis: an unusual postoperative complication

Percutaneous retrogasserian glycerol rhizolysis, introduced in 1981, has become established in the management of trigeminal neuralgia secondary to multiple sclerosis and pontine infarction. More recently, this technique was established as safe and reliable in managing pain originating from the zygapophyseal joints, with successful relief of pain in 67% of patients treated for lower back pain. In this article, we report a case of complete paralysis of lumbar paravertebral muscle function caused by severe multifidus degeneration after 3-level lumbar rhizolysis. This paralysis resulted in kyphosis and loss of sagittal balance.     

Carotido-cavernous fistula after traumatic brain injury: an unusual vascular complication

The authors reported the case of a young man who suffered a cranial traumatism and showed neurological, ophthalmic and orbital signs with orbital bruit, cranial nerve palsy and chemosis while he was in the intensive care unit. Further examinations of imagery made it possible to highlight a high-flow carotid-cavernous fistula which was the origin of these symptoms and which was successfully treated by endovascular way. The aim of this article is to remind the reader of the characteristics of this pathology, in terms of epidemiology, physiopathology, clinical and paraclinical presentation, and therapeutic care.     

Compartment syndrome of the thigh: an unusual complication after spinal surgery

Compartment syndrome of the thigh is an uncommon pathology, and its acute presentation after spinal surgery is rare. Because a large muscle mass is involved and systemic manifestations of crush syndrome and altered mental status are present, such abnormalities may lead to a delay in appropriate diagnosis and subsequent treatment. A 56-year-old man who was suspected of having a posterior compartment syndrome in the thigh after spinal decompression in the knee-chest position was evaluated clinically and with the use of a catheter for intracompartmental pressure measurement as a tool to help establish the diagnosis and monitor the evolution. Because of sciatic involvement and a demonstrated increase in the pressure in the posterior compartment with myoglobinuria and acute renal failure, prompt longitudinal fasciotomy was performed with excellent neurologic recovery and improvement of both clinical parameters and mental status.     

Chest wall arteriovenous fistula: an unusual complication after chest tube placement

Posttraumatic arteriovenous fistulas can form between vessels of the thorax that have sustained loss of integrity to the vessel wall. Although most are caused by injuries as a consequence of missile penetration or stab wounds, iatrogenic damage is a potential cause. Herein we present a case of a systemic arteriovenous fistula involving an intercostal artery and subcutaneous vein after chest tube placement.     

Actinomycosis: an unusual complication following appendicitis

We present a report of a case of retroperitoneal actinomycosis 3 years after appendectomy for a ruptured appendix. Actinomycosis is an unusual infectious disease that occasionally occurs after enteric perforation. The literature is reviewed, and the pathogenesis, diagnosis, and treatment are discussed.     

Acute parotitis: an unusual paediatric complication

Patients undergoing procedures in the prone position can develop many pressure related complications. This report describes the post-operative course of a 10-year-old girl who developed acute parotitis following a prolonged procedure performed with her in the prone position. The management of this problem is briefly discussed.