Psoas hematoma as a rare complication of posterior lumbar interbody fusion: a case report

Deng, Bo; Hong, Hai Nan; Feng, Xin Bing; Hong, Zheng; Cai, Guo Ping; Hong, Dun

doi:10.1186/s12893-020-00942-1

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…Tha similar case was a patient who suffered from hemorrhage abdominal pain and bloating after surgery. 7 This patient was initially suffering from neurostimulation in the right lower limb. As the psoas hematoma increased, the pain became persistent and more intense.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 The common sites of vascular injury caused by lumbar surgery including abdominal aorta, iliac artery and lumbar segmental artery. Risk factors of abdominal vascular injury were summarized by Liu et al 4 as (1) lumbar operation history which may lead to adhesion between retroperitoneal vessel and vertebral body (2) chronic disc disease which causes degeneration of the annulus fibrosus and anterior longitudinal ligament (3) improper use of pituitary rongeur (4) improper intraoperative position of patient (5) pressure to the abdomen in the prone position which shortens the distance between retroperitoneal vessel and vertebral body (6) proliferative spurs of anterior longitudinal ligament which may puncture major vessels (7) anterior longitudinal ligament defect (8) the abdominal radiotherapy history (9) hernia-towards-abdomen disc and (10) anatomical variations.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Psoas Hematoma After Posterior Lumbar Interbody fusion: A Case Report and Literature Review

Shi

Zhang

Chen

et al. 2023

Geriatr Orthop Surg Rehabil

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Introduction This article introduced the management of a case with severe left lower extremity pain and forced hip flexion after posterior lumbar interbody fusion and a final diagnosis of left psoas hematoma. Materials and methods Here we reported a case of a 65-year-old female received posterior lumbar interbody fusion (PLIF) for L4-L5 spondylolisthesis and L4 instability. On the postoperative day one, the hemoglobin level decreased from 108 g/L to 78 g/L. Meanwhile, the patient presented low back pain and inner thigh radiating pain (VAS pain scale = 8). The pain was so severe that it could be barely relieved by keeping left hip in flexion position. On the postoperative day 6, the pain was still severe even after taking mecobalamin, ankylosaurus, dehydrant agents and central pain relievers(VAS pain scale = 9). Computed Tomography indicated a left intramuscular hematoma image extending down to the left iliac fossa. Active hemorrhage of lumbar segmental arterial was detected by B-ultrasound. The patient then received vascular embolization under angiography on the postoperative day 7. Results The pain in the low back and inner thigh were significantly relieved after the procedure (VAS3-4). On the postoperative day nineteen, the left hip can be fully extended, but the patient was still not able to stand on left leg without a walking stick. On the postoperative day 27, she was able to walk independently. Discussion The main reason for the complication was the second conical dilation channel slipped and entered the lateral side of the vertebral body along the transverse process. After timely embolization, pain was significantly relieved and muscle strength was improved. Conclusions Angiographic embolization is an effective treatment for psoas hematoma after posterior lumbar interbody fusion.

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Section: Discussionmentioning

confidence: 99%