Lumbar cauda equina syndrome associated with the use of gelfoam: case report.

Abstract:

STUDY DESIGN:A case of cauda equina syndrome is reported. OBJECTIVE:To recognize a serious complication related to the use of Gelfoam in the lumbar spine. SUMMARY AND BACKGROUND DATA:Absorbable hemostatic gelatin sponges have long been used to control bleeding around the spinal cord. Despite widespread use and a safe history with few reported adverse reactions, Gelfoam sponges have potential for complications that may be overlooked. METHOD:A case of cauda equina syndrome is reported and discussed. RESULTS:A retained Gelfoam sponge was found in the epidural space after lumbar decompression and fusion for spinal stenosis. The retained gelatin sponge had expanded and solidified, causing a mass affect. The resultant nerve compression led to progressive myelopathy. On removal of the Gelfoam, symptoms rapidly resolved. CONCLUSIONS:Although the use of Gelfoam in spine surgery generally is considered safe, care must be taken to avoid placing a large mass of sponge in a potentially closed space. If Gelfoam is not handled properly, it can engorge and fail to be resorbed appropriately, thus causing a mass effect. If neurologic compromise develops, Gelfoam should be considered a potential cause and subsequently removed.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Friedman J,Whitecloud TS 3rd

doi

10.1097/00007632-200110150-00029

keywords:

subject

Has Abstract

pub_date

2001-10-15 00:00:00

pages

E485-7

issue

20

eissn

0362-2436

issn

1528-1159

journal_volume

26

pub_type

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