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Pulmonary thromboembolism after spinal instrumentation surgery
1Department of Orthopedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan.
Summary
A patient developed pulmonary thromboembolism after spinal surgery. Early diagnosis via pulmonary blood flow scintigraphy and prompt treatment with thrombolytics and anticoagulants saved her life.
Area of Science:
- Neurosurgery
- Cardiology
- Pulmonology
Background:
- A 57-year-old woman presented with gait disturbance and dysuria.
- Cauda equina tumor diagnosed at L2-L3 level.
Observation:
- Postoperative spinal surgery, the patient developed dyspnea and chest pain during exercise.
- Symptoms suggested pulmonary thromboembolism.
Findings:
- Diagnosis confirmed by hypoxemia on blood gas analysis and abnormal pulmonary blood flow scintigram.
- Urgent thrombolytic therapy (tisokinase, urokinase) and anticoagulation (heparin, warfarin) were administered.
Implications:
- Pulmonary thromboembolism requires early diagnosis using pulmonary blood flow scintigraphy.
- Prompt thrombolytic and anticoagulative therapies are crucial for patient survival.
- Close monitoring for pulmonary thromboembolism symptoms is essential in patients post-spinal surgery.