.png)
Challenging Life‑Saving Complex Revision Spine Surgery
- Dr Basil Al Sharef
- Jan 20
- 2 min read
Four days ago, we performed a high-risk, complex revision spine surgery on a 46-year-old patient who had undergone corrective surgery 14 months earlier for post-traumatic thoracolumbar kyphosis (T10–L2) at another institution by a different surgeon.
Unfortunately, the patient developed several serious complications following the initial procedure, including severe, therapy-resistant dorsolumbalgia, chylothorax, and recurrent syncopal episodes. Imaging revealed that the implanted cage (spacer) was significantly compressing the thoracic aorta, placing the patient at an extremely high risk of aortic rupture—estimated to be as high as 30%, with or without revision surgery.
After several weeks of meticulous preoperative planning, we performed the high-risk revision surgery last Wednesday without complications. Preoperatively, the estimated risks included up to a 30% risk of aortic rupture and a 15% risk of paraplegia due to potential spinal cord ischemia.
The patient is currently doing very well. Intraoperatively, we also confirmed pseudarthrosis (non-fusion) at the T11–T12 level.
My sincere thanks go to 𝑫𝒓. @dr.mohammedabuazab , 𝒂 𝒉𝒊𝒈𝒉𝒍𝒚 𝒆𝒙𝒑𝒆𝒓𝒊𝒆𝒏𝒄𝒆𝒅 𝒂𝒏𝒅 𝒆𝒙𝒄𝒆𝒑𝒕𝒊𝒐𝒏𝒂𝒍𝒍𝒚 𝒔𝒌𝒊𝒍𝒍𝒆𝒅 𝑮𝒆𝒓𝒎𝒂𝒏 🇩🇪 𝒃𝒐𝒂𝒓𝒅 𝒄𝒆𝒓𝒕𝒊𝒇𝒊𝒆𝒅 𝒗𝒂𝒔𝒄𝒖𝒍𝒂𝒓 𝒔𝒖𝒓𝒈𝒆𝒐𝒏, for his invaluable support in managing this urgent and extremely high-risk case. I would also like to thank the anesthesia team, operating room staff, and standby surgeons for their excellent collaboration.
𝑫𝒓 𝑩𝒂𝒔𝒊𝒍 𝑨𝒍 𝑺𝒉𝒂𝒓𝒆𝒇 𝒊𝒔 𝒈𝒆𝒓𝒎𝒂𝒏 🇩🇪𝒂𝒏𝒅 𝒔𝒘𝒊𝒔𝒔 🇨🇭𝒃𝒐𝒂𝒓𝒅 𝒄𝒆𝒓𝒕𝒊𝒇𝒊𝒆𝒅 𝑺𝒆𝒏𝒊𝒐𝒓 𝑪𝒐𝒏𝒔𝒖𝒍𝒕𝒂𝒏𝒕 𝑺𝒑𝒊𝒏𝒆 𝒂𝒏𝒅 𝑫𝒆𝒇𝒐𝒓𝒎𝒊𝒕𝒚 𝑺𝒖𝒓𝒈𝒆𝒐𝒏, 𝒘𝒉𝒐 𝒕𝒓𝒆𝒂𝒕𝒔 𝒂𝒍𝒍 𝑺𝒑𝒊𝒏𝒂𝒍 𝑷𝒂𝒕𝒉𝒐𝒍𝒐𝒈𝒊𝒆𝒔 𝐢𝐧𝐜𝐥𝐮𝐝𝐢𝐧𝐠 𝒄𝒐𝒎𝒑𝒍𝒆𝒙 𝑺𝒑𝒊𝒏𝒆 𝑺𝒖𝒓𝒈𝒆𝒓𝒚 𝒂𝒏𝒅 𝑹𝒆𝒗𝒊𝒔𝒊𝒐𝒏 𝑺𝒖𝒓𝒈𝒆𝒓𝒊𝒆𝒔.
