Ureter Injury as a Complication of Oblique Lumbar Interbody Fusion

作者：Lee Hyeong Jin; Kim Jin Sung^*; Ryu Kyeong Sik; Park Choon Keun

来源：World Neurosurgery, 2017, 102: UNSP 693.E7.

DOI：10.1016/j.wneu.2017.04.038

• Complication
• L2-L3
• Oblique lumbar interbody fusion
• Ureter

BACKGROUND: Oblique lumbar interbody fusion is a commonly used surgical method of achieving lumbar interbody fusion. There have been some reports about complications of oblique lumbar interbody fusion at the L2-L3 level. However, to our knowledge, there have been no reports about ureter injury during oblique lumbar interbody fusion. We report a case of ureter injury during oblique lumbar interbody fusion to share our experience.
CASE DESCRIPTION: A 78-year-old male patient presented with a history of lower back pain and neurogenic intermittent claudication. He was diagnosed with spinal stenosis at L2-L3, L4-L5 level and spondylolisthesis at L4-L5 level. Symptoms were not improved after several months of medical treatments. Then, oblique lumbar interbody fusion was performed at L2-L3, L4-L5 level. During the surgery, anesthesiologist noticed hematuria. A retrourethrogram was performed immediately by urologist, and ureter injury was found. Ureteroureterostomy and double-J catheter insertion were performed. The patient was discharged 2 weeks after surgery without urologic or neurologic complications. At 2 months after surgery, an intravenous pyelogram was performed, which showed an intact ureter.
CONCLUSIONS: Our study shows that a low threshold of suspicion of ureter injury and careful manipulation of retroperitoneal fat can be helpful to prevent ureter injury during oblique lumbar interbody fusion at the upper level.

• 出版日期2017-6