Topping Phenomenon with Recurrent Spinal Stenosis and Epidural Fibrosis Prevented with Oxidized Cellulose - a Case Report

Acta Medica (Hradec Králové)
Radek Hart

Abstract

Lumbar spinal stenosis is a condition where the neural structures are compressed in the narrowed spinal canal and often situated only within a single specific segment of the spine, most frequently in the lumbar spine. A case report demonstrates a surgical solution of lumbar spinal stenosis with using oxidized cellulose as a prevention of post-operative adhesions and failed back syndrome. A female patient (68) with a significant pain of the lumbar spine lasting for a number of months due to advanced spondylosis, failing to respond to conservative treatment underwent instrumented, posterolateral fusion of affected segments. The patient re-arrived with pain due to spinal stenosis in another segments after 4 and then after 3 years. We repeatedly performed spinal fusion of the affected segments and applied an antiadhesive gel to the dural sac and the decompressed nerve roots to prevent the development of post-operative adhesions and the "failed back syndrome". Last surgical solution included mobilisation of the simultaneously constricted dural sac through laminectomy. This time we covered the sac using a haemostat made of oxidized cellulose (Traumacel FAM). After this treatment, the patient was again without significant difficulties.

References

Mar 16, 2001·Clinical Orthopaedics and Related Research·K K HansrajF J Dorey
Nov 1, 2003·The Spine Journal : Official Journal of the North American Spine Society·Kathleen E RodgersRichard A Berg
Sep 15, 2004·Zeitschrift für Orthopädie und ihre Grenzgebiete·K S DelankP Eysel
Jun 14, 2006·Der Orthopäde·T L SchulteL Hackenberg
Nov 18, 2010·Journal of Korean Neurosurgical Society·Sung Bum Kim, Young Jin Lim

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