Oxidized Cellulose (Surgicel) Causing Postoperative Cauda Equine Syndrome

Area of Science:

• Neurosurgery
• Surgical Materials Science

Background:

• Hemostatic agents like oxidized cellulose (OC) are widely employed in spine surgery to manage intraoperative bleeding.
• Effective hemostasis is critical for successful surgical outcomes and patient safety.

Observation:

• A rare case of postoperative cauda equina syndrome is presented, directly linked to the presence of a retained oxidized cellulose (Surgicel) implant.
• The syndrome manifested following a spinal procedure where OC was utilized for bleeding control.

Findings:

• Complete neurological recovery was achieved following emergent surgical decompression to remove the retained oxidized cellulose material.
• The findings underscore a potential, albeit uncommon, complication associated with the use of oxidized cellulose in spinal surgery.

Implications:

• Surgeons should prioritize the complete removal of oxidized cellulose hemostatic agents after achieving hemostasis to mitigate the risk of delayed neurological complications.
• This case highlights the need for meticulous surgical technique and thorough inspection before wound closure in procedures utilizing absorbable hemostatic materials.