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Post-thoracotomy paraplegia after oxidized cellulose spinal compression.
Da Jun Than1, Vinodh Vayara Perumall1, Syamim Johan2
1Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia.
Einstein (Sao Paulo, Brazil)
|July 12, 2023
Summary
A rare case of post-thoracotomy paraplegia occurred due to oxidized cellulose gauze (Surgicel®) compressing the spinal cord after posterior mediastinal mass surgery. Surgeons must be cautious of hemostatic agents near the spinal canal.
Area of Science:
- Neurosurgery
- Thoracic Surgery
- Surgical Complications
Background:
- Posterior mediastinal masses can present with respiratory symptoms.
- Surgical resection is a primary treatment modality for such masses.
- Post-thoracotomy paraplegia is an exceptionally rare complication.
Observation:
- A 56-year-old woman underwent surgery for a posterior mediastinal mass.
- Oxidized cellulose gauze (Surgicel®) was used for hemostasis near the T4-T5 vertebral body.
- Postoperatively, the patient developed bilateral paraplegia attributed to spinal cord compression.
Findings:
- Surgicel® masses with blood clots compressed the spinal cord at the T4 and T5 levels.
- Surgical decompression and physiotherapy did not resolve the paraplegia.
- The complication arose from a hemostatic agent used near the neural foramina.
Implications:
- Surgeons must exercise extreme caution when using hemostatic agents near the spinal canal, especially during posterior mediastinal surgery.
- This case highlights a preventable cause of severe neurological deficit.
- Awareness of potential complications associated with surgical materials is crucial for patient safety.
