Postoperative bone graft migration into the thecal sac and shifting down to the lower level after an endoscopic lumbar interbody fusion: a case report

• Published in: BMC musculoskeletal disorders Vol. 24; no. 1; pp. 143 - 6
• Main Authors: Xie, Yizhou, Zhou, Qun, Wang, Yongtao, Feng, Chengzhi, Fan, Xiaohong, Yu, Yang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23.02.2023; BioMed Central; BMC
• Subjects: Bone grafts; Bone imaging; Bone-grafting; Case Report; Case reports; Case studies; Complications; Complications and side effects; Computed tomography; Endoscopic lumbar interbody fusion; Endoscopy; Endoscopy - adverse effects; Endoscopy - methods; Humans; Literature review; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Lumbosacral Region; Magnetic Resonance Imaging; Male; Medical imaging; Middle Aged; Postoperative; Postoperative bone graft migration; Postoperative Complications - diagnostic imaging; Postoperative Complications - etiology; Postoperative Complications - surgery; Reoperation; Revision surgery; Skin & tissue grafts; Spinal fusion; Spinal Fusion - adverse effects; Spinal Fusion - methods; Surgeons; Surgery; Tomography; Treatment Outcome; Urinary incontinence; China; Literature review; Case report; Revision surgery; Postoperative bone graft migration; Endoscopic lumbar interbody fusion
• DOI: 10.1186/s12891-023-06247-7
• ISSN: 1471-2474

Postoperative bone graft migration (PBGM) is a fairly rare spinal postoperative complication. Its occurrence after endoscopic surgery has rarely been reported in the literature so far. This is a case report of a 52-year-old male occurring PBGM into the thecal sac in the 8th days after an endoscopic lumbar interbody fusion (ELIF), which can make surgeons more minded with such serious rare complication after BGM. A 52-year-old male patient, underwent a L4-5 ELIF, presented with an acute radiculopathy on right leg and urinary incontinence in the 8 postoperative day. An emergency lumbar Computed Tomography(CT scan) and Magnetic Resonance Imaging (MRI) demonstrated bone graft migration into the thecal sac at the L4-5 level, and shifting down to the lower level. The revision surgery was performed at once successfully. Finally, the patient got well managed before discharge. Supported by this case report, we believe that PBGM into the thecal sac is a rare but horrible complication of ELIF. However, too much volume of bone graft and its posterior placement are more prone to developing this complication. Finally, we are not sure that the outcome presented in this study will be repeated in future cases.