Treatment of a retroperitoneal lymphocele after lumbar fusion surgery withintralesional povidone iodine: Technical case report

OBJECTIVE AND IMPORTANCE: This case report illustrates an uncommon complica tion from the retroperitoneal exposure of the lumbar spine. The diagnosis a nd management of a retroperitoneal lymphocele is presented. The lymphocele was treated with intralesional povidone iodine (Betadine; Purdue-Frederick, Norwalk, CT), which eradicated the lesion and provided symptomatic relief to the patient. CLINICAL PRESENTATION: A young woman developed an iatrogenic, rapidly progr essive spondylolisthesis after having undergone three previous lumbar surge ries for radiculopathy at the L5-S1 level. INTERVENTION: A back-front-back approach was used for operative reduction a nd fusion of the spondylolisthesis. The patient's postoperative course was complicated by a retroperitoneal lymphocele. She presented with symptoms of urinary urgency and incontinence. The lymphocele was successfully treated with repeated drainage and sclerosis with povidone iodine. The patient ulti mately developed a solid fusion, and her pain resolved. CONCLUSION: A retroperitoneal lymphocele is an uncommon complication caused by the surgical exposure of the lumbar spine when a ventral approach is us ed. In this case, it was diagnosed and treated without further surgical int ervention.