Hart A K, Greinwald J H, Shaffrey C I, Postma G N
Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center, Portsmouth, Virginia 23708-2197, USA.
J Neurosurg. 1998 Jan;88(1):151-4. doi: 10.3171/jns.1998.88.1.0151.
Chylous fistula resulting from intraoperative injury to the cervical thoracic duct is well described as a complication of neck dissection. However, injury to the thoracic duct during spinal surgery is rarely reported. The authors present the first case of thoracic duct injury occurring during cervical discectomy and fusion via an anterior approach. The anomalous location of the terminal arch of the thoracic duct in this patient contributed to the complication. The morbidity of chyle leakage is minimized by its early recognition, a thorough understanding of lymphatic system anatomy, and aggressive management of the thoracic duct injury.
术中损伤颈段胸导管导致的乳糜瘘是颈部清扫术的一种常见并发症，已有详细描述。然而，脊柱手术中胸导管损伤的报道却很少。作者报告了首例经前路颈椎间盘切除融合术中发生的胸导管损伤病例。该患者胸导管终末弓的异常位置导致了这一并发症。通过早期识别、深入了解淋巴系统解剖结构以及积极处理胸导管损伤，可将乳糜漏的发病率降至最低。
