Kansal Ritesh, Nama Santosh, Mahore Amit, Dange Nitin, Kukreja Sanjay
Seth G.S. Medical College @ K.E.M. Hospital, Department of Neurosurgery, Mumbai, India.
Turk Neurosurg. 2012;22(4):502-5. doi: 10.5137/1019-5149.JTN.3916-10.1.
Fat graft migration following spinal cord surgery is an uncommon problem. Only few cases of fat graft migration causing cauda equine syndrome, recurrent sciatica, and root compression following lumbar spine surgery have been reported. We report a case of fat graft migration causing symptomatic cervical cord compression.
A 45-years-old male with cervical spondylosis underwent anterior C4-5 discectomy and excision of hypertrophied ligament. A dural tear that occurred during the procedure was repaired with fat graft harvested from thigh. Significant improvement in stiffness was noted postoperatively. After 15 days, the patient presented again with worsening lower limbs stiffness. Magnetic resonance imaging of spine was done which revealed displacement of the fat graft causing cervical cord compression.
Re-exploration was done and the migrated fat graft was removed. Post operatively patient noticed significant improvement in stiffness in both lower limbs.
Autologous fat graft is one of the best materials used in sealing the dural cerebrospinal fluid leak during spinal surgery. However sometimes it may migrate and cause compression of cord and roots with relative symptoms. This complication should be kept in mind as removal of migrated fat graft will relieve these symptoms.
脊髓手术后脂肪移植物迁移是一个罕见的问题。仅有少数腰椎手术后脂肪移植物迁移导致马尾综合征、复发性坐骨神经痛和神经根受压的病例报道。我们报告一例脂肪移植物迁移导致症状性颈髓受压的病例。
一名45岁患有颈椎病的男性接受了C4 - 5前路椎间盘切除术和肥厚韧带切除术。术中发生硬脊膜撕裂，用从大腿采集的脂肪移植物进行修复。术后患者颈部僵硬明显改善。15天后，患者再次出现下肢僵硬加重。进行了脊柱磁共振成像检查，结果显示脂肪移植物移位导致颈髓受压。
再次进行手术探查并取出移位的脂肪移植物。术后患者注意到双下肢僵硬明显改善。
自体脂肪移植物是脊柱手术中用于封闭硬脊膜脑脊液漏的最佳材料之一。然而，有时它可能会迁移并导致脊髓和神经根受压并出现相关症状。应牢记这种并发症，因为取出移位的脂肪移植物将缓解这些症状。
