Mueller Kyle, Syed Hasan R, Rhee Jay W, Nair Mani N
Neurosurgery, Medstar Georgetown University Hospital.
Neurosurgery, Holy Cross Hospital.
Cureus. 2017 May 9;9(5):e1231. doi: 10.7759/cureus.1231.
Injury to the thoracic duct during anterior cervical spine surgery is a rare occurrence. A delayed chyle leak following an elective anterior cervical spinal surgery has not been reported in the literature. We present a report of a 59-year-old female with multiple prior neck surgeries who underwent an anterior cervical corpectomy and fusion (ACCF). The patient developed a delayed thoracic duct injury on postoperative day (POD) one, as no injury was noted intraoperatively. She was managed with conservative care involving a low-fat diet along with octreotide which led to the resolution of her symptoms. We present this case report because of its unique presentation and to assist spine surgeons with initial management. Surgeons should have increased awareness when performing anterior cervical approaches to the lower cervical and upper thoracic levels from the left side.
颈椎前路手术中胸导管损伤是一种罕见的情况。文献中尚未报道择期颈椎前路手术后出现延迟性乳糜漏。我们报告一例59岁女性，既往有多次颈部手术史，接受了颈椎前路椎体次全切除融合术（ACCF）。患者在术后第1天出现延迟性胸导管损伤，术中未发现损伤。她接受了包括低脂饮食和奥曲肽在内的保守治疗，症状得以缓解。我们呈现此病例报告是因其独特的表现，并协助脊柱外科医生进行初始处理。脊柱外科医生在从左侧对下颈椎和上胸椎水平进行颈椎前路手术时应提高警惕。
