Delayed Ureter Stricture and Kidney Atrophy After Oblique Lumbar Interbody Fusion

Oblique lumbar interbody fusion (OLIF) is a surgical technique for lumbar interbody fusion that allows surgeons to use a large cage while preserving the spine muscles. The surgical corridor of OLIF is close to the ureter in the retroperitoneal space and therefore entails a potential for injury to th...

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Bibliographic Details
Published inWorld neurosurgery Vol. 134; pp. 137 - 140
Main Authors Yoon, Sun Geon, Kim, Min Su, Kwon, Soon Chan, Lyo, In Uk, Sim, Hong Bo
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.02.2020
Subjects
Atrophy
Complication
Female
Humans
Kidney
Kidney Diseases - etiology
Lumbar Vertebrae
Middle Aged
Oblique lumbar interbody fusion
Postoperative Complications - etiology
Spinal Fusion - adverse effects
Ureter
Ureter - injuries
DLIF
Oblique lumbar interbody fusion
Complication
Ureter
GnRH
Kidney
APCT
LLIF
OLIF
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Summary:Oblique lumbar interbody fusion (OLIF) is a surgical technique for lumbar interbody fusion that allows surgeons to use a large cage while preserving the spine muscles. The surgical corridor of OLIF is close to the ureter in the retroperitoneal space and therefore entails a potential for injury to this organ. Although there are some published cases of ureteral injury that were identified during OLIF, to our knowledge, there have been no reports about delayed ureteral strictures and kidney atrophy after OLIF. We report a case of ureter stricture and ipsilateral kidney atrophy that was incidentally identified a few months postoperatively without signs of ureter injury during the operation. A 49-year-old woman presented with low back and right leg pain. On lumbar magnetic resonance imaging, a Meyerding grade 1 spondylolisthesis of L4 on L5 with L4 nerve root encroachment was confirmed. The patient underwent L4/L5 OLIF and was discharged on the 10th day after surgery with improved symptoms. Three months later, an abdominopelvic computed tomography performed for an unrelated condition showed left kidney atrophy. A retrograde ureteropyelogram confirmed a stricture near the operation site. A ureter stent was successfully inserted to overcome the stricture, but renal atrophy was not reversed. Ureter injury may be observed with several months' delay after OLIF in patients without symptoms or laboratory abnormalities, even if no direct injury was noted during the procedure.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2019.10.171