Thoracic duct injury following cervical Spine surgery: A multicenter retrospective review

Adeeb Derakhshan, Daniel Lubelski, Michael P. Steinmetz, Mark Corriveau, Sungho Lee, Jonathan R. Pace, Gabriel A. Smith, Ziya Gokaslan, Mohamad Bydon, Paul M. Arnold, Michael G. Fehlings, K. Daniel Riew, Thomas E. Mroz

Research output: Contribution to journalReview article

Abstract

Study Design: Multicenter retrospective case series. Objective: To determine the rate of thoracic duct injury during cervical spine operations. Methods: A retrospective case series study was conducted among 21 high-volume surgical centers to identify instances of thoracic duct injury during anterior cervical spine surgery. Staff at each center abstracted data for each identified case into case report forms. All case report forms were collected by the AOSpine North America Clinical Research Network Methodological Core for data processing, cleaning, and analysis. Results: Of a total of 9591 patients reviewed that underwent cervical spine surgery, 2 (0.02%) incurred iatrogenic injury to the thoracic duct. Both patients underwent a left-sided anterior cervical discectomy and fusion. The interruption of the thoracic duct was addressed intraoperatively in one patient with no residual postoperative effects. The second individual developed a chylous fluid collection approximately 2 months after the operation that required drainage via needle aspiration. Conclusions: Damage to the thoracic duct during cervical spine surgery is a relatively rare occurrence. Rapid identification of the disruption of this lymphatic vessel is critical to minimize deleterious effects of this complication.

Original languageEnglish (US)
Pages (from-to)115S-119S
JournalGlobal Spine Journal
Volume7
Issue number1_suppl
DOIs
StatePublished - Apr 1 2017
Externally publishedYes

Keywords

  • anterior
  • injury
  • spine
  • surgery
  • thoracic duct

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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  • Cite this

    Derakhshan, A., Lubelski, D., Steinmetz, M. P., Corriveau, M., Lee, S., Pace, J. R., Smith, G. A., Gokaslan, Z., Bydon, M., Arnold, P. M., Fehlings, M. G., Riew, K. D., & Mroz, T. E. (2017). Thoracic duct injury following cervical Spine surgery: A multicenter retrospective review. Global Spine Journal, 7(1_suppl), 115S-119S. https://doi.org/10.1177/2192568216688194