Unstable Lumbar Spine Osteomyelitis Caused by Trans-Foraminal Migration of Laparoscopic Adjustable Gastric Band Connection Tubing: A Case Report

Jocelyn Compton; John Yanik; Nathan Hendrickson; Naina Bagrodia; Peter Nau; Andrew J Pugley

Back

Unstable Lumbar Spine Osteomyelitis Caused by Trans-Foraminal Migration of Laparoscopic Adjustable Gastric Band Connection Tubing: A Case Report

Journal article

Open access

Peer reviewed

Unstable Lumbar Spine Osteomyelitis Caused by Trans-Foraminal Migration of Laparoscopic Adjustable Gastric Band Connection Tubing: A Case Report

Jocelyn Compton, John Yanik, Nathan Hendrickson, Naina Bagrodia, Peter Nau and Andrew J Pugley

The Iowa orthopaedic journal, Vol.40(1), pp.101-103

2020

PMCID: PMC7368515

PMID: 32742215

Appears in Diamond Open Access

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368515View

Published (Version of record) Open Access

Abstract

Disconnection of the tubing between the port and LAGB is a well-known complication in general surgery and accounts for up to 17% of LAGB complications. Typically, when this complication occurs patients present with abdominal or pelvic complaints. A complication of spinal infection due to trans-foraminal migration has not been previously reported. The aim of this study is to highlight an unusual infection of the thoracolumbar spine due to laparoscopic adjustable gastric band (LAGB) intragastric erosion, and migration into the lumbar spine causing epidural abscesses, discitis, and osteomyelitis. This case underscores the importance of a thorough surgical history, complete imaging, and multi-disciplinary approach in management of complex spine infections. We report a case of LAGB tubing migration into the spinal canal through the left L2/L3 neural foramen resulting in symptomatic epidural abscesses and osteomyelitis. Although dislodgement and migration of LAGB tubing has been reported previously, this is the first report of trans-foraminal migration and erosion of lumbar vertebrae, causing osteomyelitis of the spine and epidural abscess formation, subsequent instability and neurologic deficit requiring urgent operative intervention. Dislodgement and migration of LAGB tubing is a known complication. While it most commonly leads to abdominal and pelvic sequelae, in rare circumstances it may acutely affect the spine. Careful history, imaging, and multidisciplinary approach are paramount for the successful management. .

Anti-Bacterial Agents - therapeutic use

Foreign-Body Migration - complications

Foreign-Body Migration - microbiology

Foreign-Body Migration - surgery

Gastroplasty

Humans

Laparoscopy

Lumbar Vertebrae - microbiology

Lumbar Vertebrae - surgery

Male

Methicillin-Resistant Staphylococcus aureus

Middle Aged

Osteomyelitis - drug therapy

Osteomyelitis - microbiology

Osteomyelitis - surgery

Details

Title: Subtitle: Unstable Lumbar Spine Osteomyelitis Caused by Trans-Foraminal Migration of Laparoscopic Adjustable Gastric Band Connection Tubing: A Case Report
Creators: Jocelyn Compton - University of Iowa Hospitals and Clinics, Department of Orthopedics and Rehabilitation, Iowa City, IA
John Yanik - University of Iowa Hospitals and Clinics, Department of Orthopedics and Rehabilitation, Iowa City, IA
Nathan Hendrickson - University of Iowa
Naina Bagrodia - University of Iowa
Peter Nau - University of Iowa
Andrew J Pugley - University of Iowa Hospitals and Clinics, Department of Orthopedics and Rehabilitation, Iowa City, IA
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.40(1), pp.101-103
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
PMID: 32742215
PMCID: PMC7368515
ISSN: 1541-5457
eISSN: 1555-1377
Language: English
Date published: 2020
Academic Unit: Surgery
Record Identifier: 9984322792602771

Metrics

20 Record Views