Kim Duk-Sung, Lee Jung-Kil, Moon Kyung-Sub, Ju Jae-Kyun, Kim Soo-Han
Department of Neurosurgery, Chonnam National University Hospital & Medical School, Gwangju, Korea.
J Korean Neurosurg Soc. 2010 Mar;47(3):224-7. doi: 10.3340/jkns.2010.47.3.224. Epub 2010 Mar 31.
Small bowel injury resulting from unforeseen penetration of the anterior annulus fibrosus and longitudinal ligament is a rare complication of lumbar microdiscectomy. The patient complained of abdominal tenderness and distention immediately after microdiscectomy for L4-5 and L5-S1 disc herniation. Using abdominal computed tomography, we found several foci of air overlying the anterior aspect of the vertebral body at the L5-S1 level. Segmental resection of the small bowel including small tears and primary anastomosis of the jejunum were performed. Here, we present a case of intestinal perforation after lumbar microdiscectomy and discuss technical methods to prevent this complication with a review of literature.
腰椎间盘纤维环前部和纵韧带意外穿透导致的小肠损伤是腰椎显微椎间盘切除术罕见的并发症。该患者在接受L4 - 5和L5 - S1椎间盘突出症的显微椎间盘切除术后,立即出现腹部压痛和腹胀。通过腹部计算机断层扫描,我们在L5 - S1水平椎体前方发现了几个气体聚集灶。对小肠进行了包括小裂口在内的节段性切除,并对空肠进行了一期吻合。在此,我们报告一例腰椎显微椎间盘切除术后肠穿孔的病例,并结合文献复习讨论预防该并发症的技术方法。