Spine · 2001
Lumbar cauda equina syndrome associated with the use of gelfoam: case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Friedman J, Whitecloud T S
Аннотация
STUDY DESIGN: A case of cauda equina syndrome is reported.
OBJECTIVE: To recognize a serious complication related to the use of Gelfoam in the lumbar spine.
SUMMARY AND BACKGROUND DATA: Absorbable hemostatic gelatin sponges have long been used to control bleeding around the spinal cord. Despite widespread use and a safe history with few reported adverse reactions, Gelfoam sponges have potential for complications that may be overlooked.
METHOD: A case of cauda equina syndrome is reported and discussed.
RESULTS: A retained Gelfoam sponge was found in the epidural space after lumbar decompression and fusion for spinal stenosis. The retained gelatin sponge had expanded and solidified, causing a mass affect. The resultant nerve compression led to progressive myelopathy. On removal of the Gelfoam, symptoms rapidly resolved.
CONCLUSIONS: Although the use of Gelfoam in spine surgery generally is considered safe, care must be taken to avoid placing a large mass of sponge in a potentially closed space. If Gelfoam is not handled properly, it can engorge and fail to be resorbed appropriately, thus causing a mass effect. If neurologic compromise develops, Gelfoam should be considered a potential cause and subsequently removed.
OBJECTIVE: To recognize a serious complication related to the use of Gelfoam in the lumbar spine.
SUMMARY AND BACKGROUND DATA: Absorbable hemostatic gelatin sponges have long been used to control bleeding around the spinal cord. Despite widespread use and a safe history with few reported adverse reactions, Gelfoam sponges have potential for complications that may be overlooked.
METHOD: A case of cauda equina syndrome is reported and discussed.
RESULTS: A retained Gelfoam sponge was found in the epidural space after lumbar decompression and fusion for spinal stenosis. The retained gelatin sponge had expanded and solidified, causing a mass affect. The resultant nerve compression led to progressive myelopathy. On removal of the Gelfoam, symptoms rapidly resolved.
CONCLUSIONS: Although the use of Gelfoam in spine surgery generally is considered safe, care must be taken to avoid placing a large mass of sponge in a potentially closed space. If Gelfoam is not handled properly, it can engorge and fail to be resorbed appropriately, thus causing a mass effect. If neurologic compromise develops, Gelfoam should be considered a potential cause and subsequently removed.