Post-thoracotomy paraplegia after oxidized cellulose spinal compression

ABSTRACT Post-thoracotomy paraplegia after non-aortic surgery is an extremely uncommon complication. A 56-year-old woman presented with a 1-year history of progressive shortness of breath. Computed tomography revealed a locally advanced posterior mediastinal mass involving the ribs and the left neural foramina. Tumor excision with a left pneumonectomy was performed. Post-resection, bleeding was noted in the vicinity of the T4-T5 vertebral body, and the bleeding point was packed with oxidized cellulose gauze (Surgicel®). Postoperatively, the patient complained of bilateral leg numbness extending up to the T5 level, with bilateral paraplegia. An urgent laminectomy was performed, and we noted that the spinal cord was compressed by two masses of Surgicel® with blood clots measuring 1.5 × 1.5cm at T4 and T5 levels. The paraplegia did not improve despite the removal of the mass, sufficient decompression, and aggressive postoperative physiotherapy. Surgeons operating in fields close to the intervertebral foramen should be aware of the possible threat to the adjacent spinal canal as helpful hemostatic agents can become a preventable threat.

Hyaluronate acid and oxidized regenerated cellulose prevent adhesion reformation after adhesiolysis in rat / 重庆医学

Objective To evaluate the effect of pelvic adhesiolysis to prevent readhesion in the second look operation.Methods 30 rats underwent laparotomy incision of uterus to create intraperitoneal adhesions models.The animals were randomly divided into three groups:the first group:isotonic Na chloride (n =10);the second group:medical Sodium Hyaluronate (n =10),the third group:Oxidized regenerated cellulose.After 2-week recovery period,the animals were operated andintraperitoneal adhesions were assessed,then,all adhesions were released and set isotonic Na chloride,medical Sodium Hyaluronate and Oxidized regenerated cellulose.Again,After 2-week recovery period,the animals were killed and the intraperitoneal adhesions were assessed.Results After the first operation the three groups had significant difference (F=7.114,P＜0.05),After the second operation the three groups had no significant difference(F=0.280,P＞0.05).Conclusion Medical sodium hyaluronate and oxidized regenerated cellulose are effective methods to prevent postoperative adhesions.However,they are ineffective to prevent readhesion after adhesiolysis.