Fuller Max, Brekhus Michael
Sanford School of Medicine, University of South Dakota , Rapid City, South Dakota.
Department of Surgery, Sanford School of Medicine, University of South Dakota , Rapid City, South Dakota.
J Endourol Case Rep. 2016 Dec 1;2(1):240-242. doi: 10.1089/cren.2016.0126. eCollection 2016.
Osteophytes are bony outgrowths commonly found on lumbar vertebrae. They rarely produce complications with the most common complication being nerve entrapment, but rarer complications including aorta or inferior vena cava rupture, superior mesenteric artery syndrome, compression of the iliopsoas muscle, and cerebrospinal fluid leaks have been described. Rare cases affecting the ureter resulting in ureteral colic or extravasation of urine have been described. We describe a case in which a lumbar osteophyte bridging the L4 and L5 disks was encircling the ureter and minor trauma caused a ureteral injury, resulting in urine extravasation into the L4 and L5 disks space and the retroperitoneum. Owing to the comorbidities of this patient, this case was treated conservatively with stenting and the patient has suffered no further complications. This is a rare complication of a lumbar osteophyte but should be considered as a potential cause of ureter injury. Treatment should be individualized by patient preference and comorbidities, as some patients would elect to pursue more aggressive therapy whereas others would incline for conservative measures.
骨赘是常见于腰椎的骨质增生。它们很少引发并发症，最常见的并发症是神经受压，但也有报道称存在更罕见的并发症，包括主动脉或下腔静脉破裂、肠系膜上动脉综合征、髂腰肌受压以及脑脊液漏。已有罕见病例描述了影响输尿管导致输尿管绞痛或尿液外渗的情况。我们报告一例病例，其中一个连接L4和L5椎间盘的腰椎骨赘环绕着输尿管，轻微创伤导致输尿管损伤，尿液渗入L4和L5椎间盘间隙及腹膜后间隙。由于该患者的合并症，此病例采用支架置入保守治疗，患者未再出现进一步并发症。这是腰椎骨赘的一种罕见并发症，但应被视为输尿管损伤的一个潜在原因。治疗应根据患者的偏好和合并症个体化，因为一些患者会选择更积极的治疗方法，而另一些患者则倾向于采取保守措施。
