URETERAL INJURY AFTER ANTERIOR LUMBAR INTERBODY FUSION - A CASE-REPORT

Study Design. This case report presents a patient with ureter injury a fter anterior spinal fusion and its management. Objectives. To present possible causes, symptoms, diagnostic approach, and management of thi s rare complication. Summary of Background Data. The reported complica tions of anterior surgical approaches to the lumbar spine have been pr edominantly vascular or neurologic. The susceptibility of the ureter t o injury is emphasized by the description of an as-yet-unreported case of ureter laceration after anterior lumbar fusion. Methods. Ureter in jury was diagnosed using computed axial tomography, ultrasonography-gu ided aspiration, and chemical analysis of the aspirate after anterior spinal fusion. Results. Early diagnosis of this injury prompted a uret er stent placement and prevented additional deterioration of renal fun ction and infection. Conclusions. The ureter is prone to injury if not identified and protected when sharp and pointed instruments are used for retraction. Abdominal mass, low-grade fever, and leukocytosis shou ld prompt use of computed tomography or ultrasonography-guided aspirat ion.