Chylothorax following posterior low lumbar fusion surgery:A case report  

作　　者：Xian-Ming Huang Ming Luo Li-Yu Ran Xuan-He You Di-Wei Wu Shi-Shu Huang Quan Gong 

机构地区：[1]Department of Orthopedic Surgery and Orthopedic Research Institute,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China

出　　处：《World Journal of Clinical Cases》2021年第22期6522-6530,共9页世界临床病例杂志

基　　金：Supported by National Natural Science Foundation of China,No.81874027.

摘　　要：BACKGROUND Postoperative chylothorax is usually regarded as a complication associated with cardiothoracic surgery;however,it is one of the rare complications in orthopedic surgery.This case report describes a female patient who developed chylothorax after a successful L4-S1 transforaminal lumbar interbody fusion surgery.The etiology,diagnosis,and treatment were analyzed and discussed.CASE SUMMARY A 50-year-old woman was admitted with repeated back and leg pain.She was diagnosed with L4 degenerative spondylolisthesis,L4/L5 and L5/S1 intervertebral disc herniation and L5 instability,and underwent successful posterior L4-S1 instrumentation and fusion surgery.Unfortunately,thoracic effusion was identified 2 d after operation.The thoracic effusion was finally confirmed to be chylous based on twice positive chyle qualitative tests.The patient was discharged after 12-d persisting drainage,3-d total parenteral nutrition and fasting,and other supportive treatments.No recurring symptoms were observed within 12 mo follow-up.CONCLUSION Differential diagnosis is crucial for unusual thoracic effusion.Comprehensive diagnosis and treatment of chylothorax are necessary.Thorough intraoperative protection to relieve high thoracic pressure caused by the prone position is important.

关 键 词：CHYLOTHORAX Conservative managements Diagnosis Posterior lumbar surgery COMPLICATION Case report 

分 类 号：R687.3[医药卫生—骨科学]