Gelfoam Granuloma Formation and Myelopathy after Posterior Decompression in Thoracic Spine: A Case Report.
10.4184/jkss.2011.18.4.268
- Author:
Kyu Yeol LEE
1
;
Jin Hun KANG
;
Hyo Jong KIM
Author Information
1. Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, Korea. gylee@dau.ac.kr
- Publication Type:Case Report
- Keywords:
Gelfoam(R);
Immune reaction;
Spinal fusion
- MeSH:
Collagen;
Decompression;
Epidural Space;
Gelatin Sponge, Absorbable;
Granuloma;
Hemostasis;
Humans;
Ligamentum Flavum;
Lower Extremity;
Muscle Spasticity;
Muscle Weakness;
Spinal Cord;
Spinal Cord Diseases;
Spinal Fusion
- From:Journal of Korean Society of Spine Surgery
2011;18(4):268-272
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: A case report. OBJECTIVES: To document that Gelfoam(R) (Pharmacia & Upjohn, Kalamazoo, MI) contributes to granuloma formation and spinal cord irritation by immune response. SUMMARY OF LITERATURE REVIEW: The Gelfoam(R) or microfibrillar collagen applied during various operation for hemostasis. Some complications of Gelfoam(R), such as mechanical cord compression, postoperative swelling and mass effect in closed cavity have been reported. MATERIALS AND METHODS: The patient was underwent posterior decompression and instrumented posterolateral fusion under the diagnosis of the ossification of ligamentum flavum at T10-11 and T11-12. In operation, Gelfoam(R) was used at epidural space. She complained of sensory deterioration and muscle weakness around lower extremities after 10days postoperatively. A second operation was performed. RESULTS: Postoperatively, the patient immediately improved motor grade except spasticity. She is under observation. CONCLUSIONS: Gelfoam(R) at epidural space after posterior decompression can result hyperactive immune reaction and irritate spinal cord.
