Postoperative left-sided chylothorax following posterior approach in late-onset idiopathic scoliosis surgery

Chylothorax is an extremely rare complication of spinal surgery. We were only able to identify 15 previous cases overall, with only 5 involving a posterior approach.

A 16-year-old female presented with a chylothorax following a T4-L4 posterior spinal fusion for scoliosis. Postoperatively, the patient developed respiratory distress due to a left-sided pleural effusion. Laboratory tests (i.e., both gross and laboratory analysis) documented the fluid to be chyle. The patient required the placement of a chest drain and a low triglyceride diet to manage and resolve the chylothorax successfully.

Chylothorax is a rare complication of spinal surgery and should be considered among the differential diagnoses involving postoperative respiratory compromise attributed to pleural effusions.