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Using aneurysm clips for repair of cisterna chyli injury during posterior spinal fusion

Surgical Neurology International, 2021 · DOI: 10.25259/SNI_172_2021 · Published: August 30, 2021

ImmunologySurgery

Simple Explanation

The cisterna chyli (CC) is a crucial lymphatic sac responsible for directing lymphatic flow. Injury to this sac is a rare surgical complication that requires surgical intervention in certain instances. This paper describes a novel approach to repairing such injuries. A 60-year-old male with Parkinson's disease, who previously underwent spinal fusion, experienced a cisterna chyli laceration during a revision surgery. The injury was repaired using aneurysm clips. The patient underwent rehabilitation and was monitored for lymphedema. He showed no evidence of lymphedema during follow-up visits, suggesting a successful outcome.

Study Duration
Not specified
Participants
A 60-year-old male
Evidence Level
Case Report

Key Findings

  • 1
    Aneurysm clips can be safely and effectively used to repair cisterna chyli injuries during spinal surgery.
  • 2
    The use of poly-methyl-methacrylate cement can help to anchor the aneurysm clips in place, preventing migration and providing intervertebral support.
  • 3
    Long-term favorable clinical outcomes can be achieved with this technique.

Research Summary

This case report describes the successful use of aneurysm clips to repair a cisterna chyli (CC) injury sustained during a thoracolumbar fusion. This technique has not been previously described in literature. A 60-year-old male underwent revision spinal surgery and sustained a CC laceration, which was repaired using aneurysm clips and poly-methyl-methacrylate cement for stabilization. The patient showed improved ambulation following rehabilitation and exhibited no signs of lymphedema during follow-up, suggesting the effectiveness of this novel repair technique.

Practical Implications

Surgical Technique

Aneurysm clips offer a viable alternative for repairing cisterna chyli injuries, particularly when direct suturing is challenging.

Postoperative Management

Close monitoring for lymphedema and ascites is crucial for patients who have undergone cisterna chyli repair.

Intervertebral Support

The use of poly-methyl-methacrylate cement can provide additional stability and prevent clip migration in cases where interbody cages are not suitable.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Lack of intraoperative lymphangiography to confirm patency.
  • 3
    Patient's pre-existing Parkinson's disease complicates assessment of ambulation improvements.

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