Rhabdomyolysis and acute renal failure following minimally invasive spine surgery

2011 ◽  
Vol 14 (6) ◽  
pp. 785-788 ◽  
Author(s):  
Elias Dakwar ◽  
Stephen I. Rifkin ◽  
Ildemaro J. Volcan ◽  
J. Allan Goodrich ◽  
Juan S. Uribe
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Spine Surgery ◽  
Operative Time ◽  
Case Series ◽  
Potential Complication ◽  
Minimally Invasive Spine ◽  
The Mean

Minimally invasive spine surgery is increasingly used to treat various spinal pathologies with the goal of minimizing destruction of the surrounding tissues. Rhabdomyolysis (RM) is a rare but known complication of spine surgery, and acute renal failure (ARF) is in turn a potential complication of severe RM. The authors report the first known case series of RM and ARF following minimally invasive lateral spine surgery. The authors retrospectively reviewed data in all consecutive patients who underwent a minimally invasive lateral transpsoas approach for interbody fusion with the subsequent development of RM and ARF at 2 institutions between 2006 and 2009. Demographic variables, patient home medications, preoperative laboratory values, and anesthetic used during the procedure were reviewed. All patient data were recorded including the operative procedure, patient positioning, postoperative hospital course, operative time, blood loss, creatine phosphokinase (CPK), creatinine, duration of hospital stay, and complications. Five of 315 consecutive patients were identified with RM and ARF after undergoing minimally invasive lateral transpsoas spine surgery. There were 4 men and 1 woman with a mean age of 66 years (range 60–71 years). The mean body mass index was 31 kg/m2 and ranged from 25 to 40 kg/m2. Nineteen interbody levels had been fused, with a range of 3–6 levels per patient. The mean operative time was 420 minutes and ranged from 315 to 600 minutes. The CPK ranged from 5000 to 56,000 U/L, with a mean of 25,861 U/L. Two of the 5 patients required temporary hemodialysis, while 3 required only aggressive fluid resuscitation. The mean duration of the hospital stay was 12 days, with a range of 3–25 days Rhabdomyolysis is a rare but known potential complication of spine surgery. The authors describe the first case series associated with the minimally invasive lateral approach. Surgeons must be aware of the possibility of postoperative RM and ARF, particularly in morbidly obese patients and in procedures associated with prolonged operative times.

scholarly journals MINILAPAROSCOPIC APPENDECTOMY

2016 ◽  
Vol 29 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Lúcio Américo Della COLETTA ◽  
Bruno Ziade GIL ◽  
Renato Morato ZANATTO
Keyword(s):  
Acute Appendicitis ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Operative Time ◽  
Treatment Method ◽  
Public Health Services ◽  
Surgical Time ◽  
Aesthetic Result ◽  
The Mean ◽  
The Aesthetic

Background: Minilaparoscopy is considered one of the minimally invasive options available for acute appendicitis treatment, although not always employed in less complexity public health services. Aim: Report surgical outcomes of minilaparoscopy use in acute appendicitis treatment. Method : The study included 21 patients undergoing minilaparoscopic appendectomy with instrumental of 3 mm. The following variables were analyzed: sex, age, body mass index, stage of appendicitis, surgical time, hospital stay, surgical complications, conversion rate to conventional laparoscopy or laparotomy, pain after surgery and aesthetic result. Results: Twelve men and nine women underwent minilaparoscopic appendectomy. The average age was 27,8 years, the mean BMI was 24,8 kg/m2. The operative time ranged from 33 to 160 min and the average of hospital stay was three days. Among the 21 patients, 20 reported mild pain or no pain in the first postoperative day. The aesthetic result was considered "satisfactory" and "very satisfactory" by 95% of the patients. Conclusions: The minilaparoscopy is viable technique for treating acute appendicitis with a satisfactory recovery. It combines the benefits of minimally invasive procedures with results similar to conventional techniques.

scholarly journals MINIMALLY INVASIVE SPINE SURGERY IN THE NUEVO HOSPITAL CIVIL DE GUADALAJARA "DR. JUAN I. MENCHACA"

2016 ◽  
Vol 15 (4) ◽  
pp. 267-271
Author(s):  
MIGUEL ÁNGEL ANDRADE-RAMOS ◽  
YAZMÍN LEMUS-RODRÍGUEZ ◽  
EDGAR FERNANDO ACOSTA-GÓMEZ ◽  
SERGIO VALENTE ESPARZA-GUTIÉRREZ ◽  
FRANCISCO GUERRERO-JAZO ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hospital Stay ◽  
Spine Surgery ◽  
Case Series ◽  
Neurological Status ◽  
Minimal Invasive ◽  
Bleeding Complications ◽  
Short Term ◽  
Adjacent Structures

ABSTRACT Objective: To describe our experience on a case series treated with minimal invasive techniques in spine surgery, with short-term follow-up and identify complications. Methods: A prospective analysis was performed on 116 patients operated on by the same team from September 2015 to June 2016. Evaluating the short-term follow-up we registered the surgical time, bleeding, complications, hospital stay, pre- and postoperatively neurological status, as well as scales of disability and quality of life. Demographic and surgical procedure data were analyzed with SPSS version 20 program. Results: A total of 116 patients with a mean age of 49.7 + 15.7 (21-85 years) underwent surgery being 76 (65%) with lumbar conditions and 37 (32%) with cervical conditions. The most common procedures were tubular discectomies (31), tubular bilateral decompression (17), lumbar MI-TLIFs (7), and anterior cervical discectomy and fusion (35). The mean blood loss was 50.6 cc, the hospital stay was 1.7 day, pre- and postoperative pain VAS were 7.4 % and 2.3%, respectively, pre- and postoperative Oswestry (ODI) were 64.6% and 13.1%, respectively, pre- and postoperative SF-36 of 37.8% and 90.3%. There were no major complications, except for a surgical wound infection in diabetic patient and three incidental durotomies, one of these being a contained fistula, treated conservatively. Conclusions: The current tendency towards minimally invasive surgery has been justified on multiple studies in neoplastic and degenerative diseases, with the preservation of the structures that support the spine biomechanics. The benefits should not replace the primary objectives of surgery and its usefulness depends on the skills of the surgeon, pathology and the adequate selection of the techniques. We found that the tubular access allows developing techniques such as discectomy, corpectomy and fusion without limiting exposure, avoiding manipulation of adjacent structures, reducing complications and being feasible in a public hospital.

scholarly journals Minimally invasive spine surgery in the pediatric and adolescent population: A case series

2018 ◽  
Vol 9 (1) ◽  
pp. 116 ◽  
Author(s):  
Richard Menger ◽  
MatthewI Hefner ◽  
AmeyR Savardekar ◽  
Anil Nanda ◽  
Anthony Sin
Keyword(s):  
Minimally Invasive ◽  
Spine Surgery ◽  
Case Series ◽  
Minimally Invasive Spine Surgery ◽  
Adolescent Population ◽  
Minimally Invasive Spine

Safety of Early Mobilization in Patients With Intraoperative Cerebrospinal Fluid Leak in Minimally Invasive Spine Surgery: A Case Series

2021 ◽  
Author(s):  
Majid Aljoghaiman ◽  
Yosef Ellenbogen ◽  
Radwan Takroni ◽  
Kaiyun Yang ◽  
Forough Farrokhyar ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Minimally Invasive ◽  
Spine Surgery ◽  
Subdural Hematoma ◽  
Case Series ◽  
Early Mobilization ◽  
Cerebrospinal Fluid Leak ◽  
Minimally Invasive Spine Surgery ◽  
Csf Leak ◽  
Minimally Invasive Spine

Abstract BACKGROUND Cerebrospinal fluid (CSF) leak is a common complication in spine surgery. Repairing durotomy is more difficult in the setting of minimally invasive spine surgery (MISS). Efficacy of postoperative bed rest in case of dural tear in MISS is not clear. OBJECTIVE To assess the safety and efficacy of our protocol of dura closure without changing access, early mobilization, and discharge in cases of intraoperative CSF leak in MISS. METHODS A retrospective review from 2006 to 2018 of patients who underwent MISS for degenerative and neoplastic diseases with documented accidental or intentional durotomy was conducted. The primary outcome of interest was readmission rate for repair of persistent CSF leak. Secondary outcomes captured included development of pseudomeningocele, positional headache, and subdural hematoma. RESULTS A total of 80 patients were identified out of 527 patients. Of these, intentional durotomy was performed in 28 patients and unintentional durotomy occurred in 52 patients. Mean follow-up period was 80.6 mo. Most of the patients were discharged on postoperative day 0 (within 4 h of surgery) without activity restrictions. A total of 2 (2.5%) patients required readmission and dural repair for continuous CSF leak and 3 patients (3.75%) developed pseudomeningocele. No lumbar drain insertion, meningitis, or subdural hematoma was reported. CONCLUSION Early mobilization and discharge in cases of intraoperative CSF leak in MISS appear to be safe and not associated with higher rate of complications than that of reported literature.

scholarly journals Minimally invasive resection of lumbar intraspinal synovial cysts via a contralateral approach: review of 13 cases

2015 ◽  
Vol 23 (4) ◽  
pp. 444-450 ◽  
Author(s):  
Hamdi G. Sukkarieh ◽  
Patrick W. Hitchon ◽  
Olatilewa Awe ◽  
Jennifer Noeller
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Operative Time ◽  
Synovial Cyst ◽  
Contralateral Approach ◽  
Estimated Blood Loss ◽  
Synovial Cysts ◽  
The Mean

OBJECT The authors sought to determine patient-related outcomes after minimally invasive surgical (MIS) lumbar intraspinal synovial cyst excision via a tubular working channel and a contralateral facet-sparing approach. METHODS All the patients with a symptomatic lumbar intraspinal synovial cyst who underwent surgery at the University of Iowa Hospitals and Clinics with an MIS excision via a contralateral approach were treated between July 2010 and August 2014. There was a total of 13 cases. Each patient was evaluated with preoperative neurological examinations, lumbar spine radiography, MRI, and visual analog scale (VAS) scores. The patients were evaluated postoperatively with neurological examinations and VAS and Macnab scores. The primary outcomes were improvement in VAS and Macnab scores. Secondary outcomes were average blood loss, hospital stay duration, and operative times. RESULTS There were 5 males and 8 females. The mean age was 66 years, and the mean body mass index was 28.5 kg/m2. Sixty-nine percent (9 of 13) of the cysts were at L4–5. Most patients had low-back pain and radicular pain, and one-third of them had Grade 1 spondylolisthesis. The mean (± SD) follow-up duration was 20.8 ± 16.9 months. The mean Macnab score was 3.4 ± 1.0, and the VAS score decreased from 7.8 preoperatively to 2.9 postoperatively. The mean operative time was 123 ± 30 minutes, with a mean estimated blood loss of 44 ± 29 ml. Hospital stay averaged 1.5 ± 0.7 days. There were no complications noted in this series. CONCLUSIONS The MIS excision of lumbar intraspinal synovial cysts via a contralateral approach offers excellent exposure to the cyst and spares the facet joint at the involved level, thus minimizing risk of instability, blood loss, operative time, and hospital stay. Prospective randomized trials with longer follow-up times and larger cohorts are needed to conclusively determine the superiority of the contralateral MIS approach over others, including open or ipsilateral minimally invasive surgery.

Management of incidental durotomy in minimally invasive spine surgery

2011 ◽  
Vol 31 (4) ◽  
pp. E15 ◽  
Author(s):  
Dmitry Ruban ◽  
John E. O'Toole
Keyword(s):  
Minimally Invasive ◽  
Spine Surgery ◽  
Minimally Invasive Spine Surgery ◽  
Hospital Length Of Stay ◽  
Consecutive Series ◽  
Csf Fistula ◽  
Estimated Blood Loss ◽  
Cervical Surgery ◽  
Minimally Invasive Spine ◽  
The Mean

Object Unintended durotomy is one of the most common complications in spine surgery that may lead to serious complications if not recognized or treated properly. There are few reports on the management of durotomies incurred during minimally invasive spine surgery (MISS). The authors describe their experience in a series of consecutive MISS patients with unintended durotomies. Methods All patients who underwent MISS by the senior author between August 2006 and February 2011 were retrospectively reviewed, and cases with unintended durotomies were identified. A case-control study was carried out comparing patient demographics and perioperative data between patients with and without durotomy. Surgical technique, including a proposed algorithm for management of durotomies, is described. Results Unintended durotomy occurred in 53 (9.4%) of 563 patients. The mean age at surgery was 60.7 years (range 30–85 years). Previous surgery at the same level was performed in 5 patients (9.4%). Two patients underwent posterior cervical surgery, and 51 patients underwent posterior lumbar surgery. Decompression alone was performed in 32 patients (60.4%), and fusion was performed in 21 patients (39.6%). The mean operative time was 105 minutes in the decompression group and 310 minutes in the fusion group (p < 0.001). Estimated blood loss was 60 ml in the decompression group and 381 ml in the fusion group (p < 0.001). The hospital length of stay was 52 hours in the decompression group and 106 hours in the fusion group (p < 0.001). The mean follow-up was 310 days, and there were no cases of cutaneous CSF fistula, pseudomeningocele, or other complications referable to durotomy in either group. Risk factors identified for durotomy included previous operation at the same level (p = 0.019) and operation in the lumbar spine region (p = 0.001). Conclusions In the authors' consecutive series of patients undergoing MISS, an unintended durotomy was associated with fewer complications than previously reported for open spinal surgery. The authors propose a simple management algorithm that includes early mobilization and results in excellent clinical outcomes with no incidence of postoperative cutaneous CSF fistula or other complications.

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