Chylous leakage after circumferential thoracolumbar fusion for correction of kyphosis resulting from fracture - Report of three cases

Study Design. A description of the clinical picture of chylous leakage after spinal surgery. Objectives. To present the clinical course of three cases of chylous leakage after spinal surgery and to discuss the pathogenesis of the disease. Summary of Background Data. Chylous leakage is a rare complication after spinal surgery. It has been attributed to direct injury of a lymphatic trunk or one of its major tributaries by surgical maneuver. Methods. Three cases of chylous leakage after circumferential thoracolumbar fusion for correction of kyphosis resulting from fracture were reported. Results. All of the three cases were managed successfully; two cases of chyloretroperitoneum detected within 4 days after surgery were healed conservatively, but one case of chylothorax, of which the onset was noticed 5 weeks after spinal surgery, required surgical ligation of the thoracic duct and pleurodesis. Conclusion. Early detection of this disease is important for a good prognosis. Retroperitoneal drainage is necessary for the detection and management of chyloretroperitoneum. The pathogenesis and management of the chylous leakage are discussed in this report.