A rare cause of postoperative paraplegia in minimally invasive spine surgery

Spine (Phila Pa 1976). 2014 Feb 1;39(3):E228-30. doi: 10.1097/BRS.0000000000000092.

Abstract

Study design: A case report.

Objective: To present a patient who underwent a minimally invasive transforaminal lumbar interbody fusion who postoperatively developed paraplegia as a rare complication of a Kirschner wire (K-wire).

Summary of background data: The few complications of K-wires that have been reported include, dural tears and damage to intra-abdominal structures.

Methods: A case report of a rare complication of a K-wire is reported and the relevant literature was then reviewed.

Results: An 85-year-old female with an anterolisthesis at L4-L5 underwent a minimally invasive transforaminal lumbar interbody fusion. Postoperatively she developed paraplegia. A subdural hematoma from T12 to the sacrum was found and evacuated. It is proposed that this rare complication is a result of a K-wire.

Conclusion: Care must be taken with the use of K-wires and additional measures should be carried out such as the marking of its position and radiological confirmation of depth.

Level of evidence: 5.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Bone Wires / adverse effects*
  • Female
  • Humans
  • Lumbar Vertebrae / diagnostic imaging*
  • Lumbar Vertebrae / surgery
  • Minimally Invasive Surgical Procedures / adverse effects*
  • Minimally Invasive Surgical Procedures / instrumentation
  • Paraplegia / diagnostic imaging*
  • Paraplegia / etiology
  • Postoperative Complications / diagnostic imaging*
  • Postoperative Complications / etiology
  • Radiography
  • Spinal Fusion / adverse effects
  • Spinal Fusion / instrumentation