Splenic rupture related to thoracoscopic spine surgery.

Abstract

Case report and review of the literature. We report a case of splenic rupture in association with thoracoscopic spine surgery. Complications of thoracoscopic spine surgery have been reported in the literature, including pleural effusion, pneumothorax, chyle thorax, intercostal neuralgia, cerebrospinal fluid fistula, lung injury, and great vessel injury. Although it has been reported to have occurred with other endoscopic procedures, splenic rupture has not been reported in association with thoracoscopic spine surgery. A 60-year-old man with a T12 spine lesion underwent T12 corpectomy and fusion using a thoracoscopic approach. Intraoperatively, he became hemodynamically unstable, and postoperative abdominal computed tomography was consistent with splenic rupture. He underwent emergent splenectomy and has made a good recovery. This case describes how retraction on the diaphragm during thoracoscopic spine surgery can lead to splenic injury. A high index of suspicion should be maintained in cases in which hemodynamic instability is identified despite a clean surgical field.