Fat graft migration causing recurrent cervical cord compression.

AIM: Fat graft migration following spinal cord surgery is an uncommon problem. Only few cases of fat graft migration causing cauda equine syndrome, recurrent sciatica, and root compression following lumbar spine surgery have been reported. We report a case of fat graft migration causing symptomatic cervical cord compression.

MATERIAL AND

METHODS

A 45-years-old male with cervical spondylosis underwent anterior C4-5 discectomy and excision of hypertrophied ligament. A dural tear that occurred during the procedure was repaired with fat graft harvested from thigh. Significant improvement in stiffness was noted postoperatively. After 15 days, the patient presented again with worsening lower limbs stiffness. Magnetic resonance imaging of spine was done which revealed displacement of the fat graft causing cervical cord compression.

RESULTS

Re-exploration was done and the migrated fat graft was removed. Post operatively patient noticed significant improvement in stiffness in both lower limbs.

CONCLUSION

Autologous fat graft is one of the best materials used in sealing the dural cerebrospinal fluid leak during spinal surgery. However sometimes it may migrate and cause compression of cord and roots with relative symptoms. This complication should be kept in mind as removal of migrated fat graft will relieve these symptoms.