TY - JOUR
T1 - Entero-paraspinous fistula from recurrent spinal metastatic renal cell carcinoma
AU - Reddy, Ambur
AU - Hitchon, Patrick W.
AU - Al-Nafi, Sami
AU - Choi, Kent
N1 - Publisher Copyright:
©AANS, 2015.
PY - 2015/1
Y1 - 2015/1
N2 - The authors report a case of entero-paraspinous fistula 2 years after T-12 corpectomy and instrumentation for spinal metastasis from renal cell carcinoma. The pathogenesis in the present case seems to have arisen from local recurrence of T-12 metastatic carcinoma in spite of radiation and corpectomy. As a result of previous nephrectomy and anterolateral dissection for the T-12 corpectomy, the jejunum adhered to the surgical site. Recurrent tumor at T-12 invaded the adherent small bowel loop, resulting in a fistulous communication between the small bowel lumen and the spinal wound. Loss of retroperitoneal fat, scarring, and adhesions from previous surgeries contributed to this complication by having the jejunum close to the T-12 corpectomy site, and eventually to its invasion by recurrent tumor. Avoidance of such a complication is difficult; however, total excision of the spinal malignancy, and when possible, creating a barrier cuff of fascia or fat around the spine to protect abdominal contents, are potential solutions.
AB - The authors report a case of entero-paraspinous fistula 2 years after T-12 corpectomy and instrumentation for spinal metastasis from renal cell carcinoma. The pathogenesis in the present case seems to have arisen from local recurrence of T-12 metastatic carcinoma in spite of radiation and corpectomy. As a result of previous nephrectomy and anterolateral dissection for the T-12 corpectomy, the jejunum adhered to the surgical site. Recurrent tumor at T-12 invaded the adherent small bowel loop, resulting in a fistulous communication between the small bowel lumen and the spinal wound. Loss of retroperitoneal fat, scarring, and adhesions from previous surgeries contributed to this complication by having the jejunum close to the T-12 corpectomy site, and eventually to its invasion by recurrent tumor. Avoidance of such a complication is difficult; however, total excision of the spinal malignancy, and when possible, creating a barrier cuff of fascia or fat around the spine to protect abdominal contents, are potential solutions.
KW - Anterior spinal instrumentation
KW - Entero-spinal fistula
KW - Oncology
KW - Spinal metastatic tumor
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U2 - 10.3171/2014.10.SPINE14294
DO - 10.3171/2014.10.SPINE14294
M3 - Article
C2 - 25396260
AN - SCOPUS:84925283453
SN - 1547-5654
VL - 22
SP - 60
EP - 63
JO - Journal of Neurosurgery: Spine
JF - Journal of Neurosurgery: Spine
IS - 1
ER -