Entero-paraspinous fistula from recurrent spinal metastatic renal cell carcinoma

Ambur Reddy, Patrick W. Hitchon, Sami Al-Nafi, Kent Choi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)60-63
Number of pages4
JournalJournal of Neurosurgery: Spine
Volume22
Issue number1
DOIs
StatePublished - Jan 2015
Externally publishedYes

Keywords

  • Anterior spinal instrumentation
  • Entero-spinal fistula
  • Oncology
  • Spinal metastatic tumor

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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