Retroperitoneal Hematoma Due to Drainage Tube Insertion in Extreme Lateral Interbody Fusion: A Case Report

A 73-year-old woman presented with degenerative kyphoscoliosis. Radiographs revealed sagittal and coronal imbalance with lumbar spinal stenosis. Extreme lateral interbody fusion (XLIF) was performed in the first stage of 2-stage surgery, and a closed-suction drainage tube was placed in the retroperitoneal cavity. Postoperatively, there was massive bleeding through the tube. Contrast-enhanced computed tomography revealed lumbar artery injury, which required emergency arterial embolization.

Placing a drainage tube in the retroperitoneal cavity during XLIF surgery can help detect complications such as intestinal and ureteral injuries, the lumbar artery within the lumbar muscle can be injured during drain placement.