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European Spine Journal

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01-06-2019 | Case Report

Chylous fistula: management of a rare complication following right anterior cervical spine approach

Authors: Federica Novegno, Pierluigi Granaroli, Luigi Ciccoritti, Pierpaolo Lunardi, Mario Francesco Fraioli

Published in: European Spine Journal | Special Issue 2/2019

Abstract

Purpose

Chylorrhea resulting from injury of the lymphatic system during neck dissection is a well-known complication. It is an uncommon occurrence in spinal surgery, and only one case after right anterior cervical spine surgery has been described so far. Despite its rarity, chylous leakage deserves a particular attention since it may become a serious and occasionally fatal complication if not detected early and managed appropriately.

Methods

We report the case of a 42-year-old man who underwent a standard anterior cervical discectomy and fusion according to Cloward approach for a C6–C7 disk herniation. The patient developed a delayed prevertebral chyle collection on postoperative day 5, presenting with mild breathing and swallowing difficulties.

Results

He was managed with conservative care, including bed rest, low-fat diet and drainage pouch positioning, which led to the complete resolution of the fluid collection.

Conclusions

Knowledge of the normal anatomy of the lymphatic system and of its variations is essential when planning an anterior spinal procedure, and represents the first measure to be adopted in order to avoid such complication. The prompt identification of a postoperative chylous fistula and the applicability of an individually based management’s protocol may help in the majority of the cases to reduce the potential morbidity, without significant long-term effects.

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Title: Chylous fistula: management of a rare complication following right anterior cervical spine approach
Authors: Federica Novegno
Pierluigi Granaroli
Luigi Ciccoritti
Pierpaolo Lunardi
Mario Francesco Fraioli
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue Special Issue 2/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-019-05929-y

2024 ASCO Annual Meeting

Springer Medicine

Chylous fistula: management of a rare complication following right anterior cervical spine approach

Abstract

Purpose

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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