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Acta Neurochir (2013) 155:12431244 DOI 10.1007/s00701-013-1703-3
LETTER TO THE EDITOR - SPINE
Delayed paraplegia due to surgiceloma following thoracotomy for a Pancoast tumor
Bawarjan Schatlo & Antoine-Flavien Eger & Karl Schaller &
Enrico Tessitore
Received: 21 March 2013 /Accepted: 26 March 2013 /Published online: 17 April 2013 # Springer-Verlag Wien 2013
Dear Editor,Oxidized regenerated cellulose (ORC, Surgicel, Ethicon Inc.) is widely used as a hemostatic fleece. The manufacturer recommends removing as much ORC as possible before closure. As one of the possible complications of its use, postoperative neurological compression symptoms caused by so-called surgiceloma have been described in the spine [1] and brain [2, 4]. Since this entity regularly occurs despite better knowledge, we would like to share our experience with a catastrophic complication following the inappropriate use of ORC in spinal surgery.
A 54-year-old male underwent posterolateral thoracotomy for a Pancoast tumor T4N0M0 of the right upper pulmonary lobe with infiltration of the vertebral body of Th2 at another institution. The patient awoke from surgery without neurological deficits. On postoperative day 1, he fell asleep in the afternoon and woke up with paraplegia and complete sensory loss in his right leg. An emergency MRI showed a mass lesion within the spinal canal at the Th2...