High rectal injury during trans-1 axial lumbar interbody fusion L5-S1 fixation: a case report

Spine
Sergiu BotolinEvalina Burger

Abstract

A case report. To report a case of high rectal injury during trans-1 axial Lumbar Interbody Fusion (axiaLIF) L5-S1 fixation. Trans-1 axiaLIF procedure is gaining in popularity for L5-S1 fusion due to the ease of access to the sacrum through the presacral space. Normally, the midline of the sacrum at S1-S2 is relatively free from neurovascular and intra-abdominal structures, making this level a safe entry point for the axiaLIF procedure. We report a case of high rectal injury during Trans-1 axiaLIF L5-S1 procedure due to altered intra-abdominal anatomy as a result of multifactorial adhesions formation. A 44-year-old female patient with a history of previous anterior and posterior spinal surgeries, pelvic inflammatory disease, and non-disclosed previous diverticulitis, developed a high rectal injury during Trans-1 axiaLIF L5-S1 fixation. After Trans-1 axiaLIF L5-S1, the patient presented with an episode of melena and hypogastric pain with nausea and vomiting. A computed tomography (CT) scan of the abdomen with intravenous and oral contrast showed presacral soft tissue fluid density with fat stranding and extraluminal rectal contrast and gas with some areas of soft tissue enhancement compatible with probable high rectal perforatio...Continue Reading

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Citations

Jul 23, 2013·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Paul S Issack, Oheneba Boachie-Adjei
May 24, 2011·Journal of Neurosurgery. Spine·Emily M LindleyVikas V Patel
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