{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:32:11Z","timestamp":1769729531729,"version":"3.49.0"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,7,15]]},"abstract":"\n BACKGROUND<\/jats:title>\n The prone lateral approach to lumbar spine surgery is known to have a multitude of potential complications, including damage to neurovascular structures, surrounding viscera, and intra-abdominal structures near the surgical site. However, iatrogenic injury to the spleen following prone lateral lumbar discectomy and arthrodesis as a potential complication has not yet been described in the literature.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The authors present the case of a 71-year-old female with a history of L3\u2013S1 laminectomy and L3\u20135 arthrodesis who underwent a prone lateral discectomy of L2\u20133 with arthrodesis of the endplates for chronic lower-back pain. On postoperative day 1, the patient developed hypotension unresponsive to pressor medications, significant abdominal pain, and anemia requiring 2 transfusions. Bedside ultrasound revealed free fluid in the abdomen. She then underwent an exploratory laparotomy for splenic injury.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Although rare, splenic rupture should be considered as part of the differential diagnosis for patients with hemodynamic instability after lateral surgical approaches to the lumbar spine. Any patient with evidence of hypotension, anemia, and\/or abdominal pain following lumbar surgery should be evaluated for splenic injury with an abdominal computed tomography scan and considered for surgical intervention.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE23639<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case23639","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T02:50:49Z","timestamp":1721011849000},"source":"Crossref","is-referenced-by-count":0,"title":["Splenic rupture following prone lateral discectomy and arthrodesis: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Alexandra","family":"Echevarria","sequence":"first","affiliation":[{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Hempstead, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Hershfeld","sequence":"additional","affiliation":[{"name":"Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Hempstead, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Arciero","sequence":"additional","affiliation":[{"name":"Northwell Health Department of Orthopedic Surgery, NorthShore University Hospital, Manhasset, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Verma","sequence":"additional","affiliation":[{"name":"Northwell Health Department of Orthopedic Surgery, NorthShore University Hospital, Manhasset, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"J Spine Surg","first-page":"2","article-title":"Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF","volume":"1","author":"Mobbs","year":"2015","unstructured":"Mobbs RJPhan KMalham GSeex KRao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF. J Spine Surg. 2015;1(1):2-18."},{"issue":"2","key":"bib2","series-title":"Medicina (Kaunas)","first-page":"251","article-title":"The prone lateral approach for lumbar fusion\u2014a review of the literature and case series","volume":"59","author":"Barkay","year":"2023","unstructured":"Barkay GWellington IMallozzi SSingh HMoss IL. The prone lateral approach for lumbar fusion\u2014a review of the literature and case series. Medicina (Kaunas). 2023;59(2):251."},{"issue":"7496","key":"bib3","series-title":"BMJ","first-page":"889","article-title":"A life threatening complication after colonoscopy","volume":"330","author":"Janes","year":"2005","unstructured":"Janes SEJCowan IADijkstra B. A life threatening complication after colonoscopy. BMJ. 2005;330(7496):889-890."},{"issue":"4","key":"bib4","series-title":"Eur Spine J","first-page":"800","article-title":"Incidence of vascular complications during lateral lumbar interbody fusion: an examination of the mini-open access technique","volume":"24","author":"Kueper","year":"2015","unstructured":"Kueper JFantini GAWalker BRAichmair AHughes AP. Incidence of vascular complications during lateral lumbar interbody fusion: an examination of the mini-open access technique. Eur Spine J. 2015;24(4):800-809."},{"issue":"1","key":"bib5","series-title":"Open Med (Wars)","first-page":"307","article-title":"Iatrogenic splenic injury: review of the literature and medico-legal issues","volume":"11","author":"Feola","year":"2016","unstructured":"Feola ANiola MConti A, et al. Iatrogenic splenic injury: review of the literature and medico-legal issues. Open Med (Wars). 2016;11(1):307-315."},{"issue":"2","key":"bib6","series-title":"Clin Anat N Y N","first-page":"212","article-title":"Anatomic mechanisms for splenic injury during colorectal surgery","volume":"25","author":"Merchea","year":"2012","unstructured":"Merchea ADozois EJWang JKLarson DW. Anatomic mechanisms for splenic injury during colorectal surgery. Clin Anat N Y N. 2012;25(2):212-217."},{"issue":"6","key":"bib7","series-title":"J R Coll Surg Edinb","first-page":"731","article-title":"Iatrogenic splenic injury","volume":"47","author":"Cassar","year":"2002","unstructured":"Cassar KMunro A. Iatrogenic splenic injury. J R Coll Surg Edinb. 2002;47(6):731-741."},{"issue":"3","key":"bib8","series-title":"Langenbecks Arch Chir","first-page":"207","article-title":"Der Bandapparat der Milz und seine Bedeutung bei chirurgischen Eingriffen.","volume":"371","author":"Ostermann","year":"1987","unstructured":"Ostermann PASchreiber HWLierse W. Der Bandapparat der Milz und seine Bedeutung bei chirurgischen Eingriffen.The ligament system of the spleen and its significance for surgical interventions. Langenbecks Arch Chir. 1987;371(3):207-216."},{"issue":"9","key":"bib9","series-title":"Clin Orthop Relat Res","first-page":"2271","article-title":"Case reports: splenic rupture after anterior thoracolumbar spinal fusion through a thoracoabdominal approach","volume":"466","author":"Heyworth","year":"2008","unstructured":"Heyworth BESchwab JHBoachie-Adjei OB. Case reports: splenic rupture after anterior thoracolumbar spinal fusion through a thoracoabdominal approach. Clin Orthop Relat Res. 2008;466(9):2271-2275."},{"issue":"suppl 4","key":"bib10","series-title":"Eur Spine J","first-page":"S569","article-title":"Rupture of the spleen following thoracoscopic spine surgery in a patient with chronic pancreatitis","volume":"24","author":"Bogner","year":"2015","unstructured":"Bogner RResch HMayer MLederer SOrtmaier R. Rupture of the spleen following thoracoscopic spine surgery in a patient with chronic pancreatitis. Eur Spine J. 2015;24(suppl 4):S569-S572."},{"issue":"3","key":"bib11","series-title":"J Bone Joint Surg Am","first-page":"396","article-title":"Splenic injury complicating the anterior thoracoabdominal surgical approach for scoliosis. A report of two cases","volume":"65","author":"Hodge","year":"1983","unstructured":"Hodge WADeWald RL. Splenic injury complicating the anterior thoracoabdominal surgical approach for scoliosis. A report of two cases. J Bone Joint Surg Am. 1983;65(3):396-397."},{"issue":"5","key":"bib12","series-title":"J Pediatr Orthop","first-page":"537","article-title":"Spleen rupture after surgery in Marfan syndrome scoliosis","volume":"24","author":"Christodoulou","year":"2004","unstructured":"Christodoulou AGPloumis ATerzidis IPTimiliotou KGerogianni NSpyridis C. Spleen rupture after surgery in Marfan syndrome scoliosis. J Pediatr Orthop. 2004;24(5):537-540."},{"key":"bib13","series-title":"World Neurosurg","first-page":"e11","article-title":"Comparison of prone transpsoas and standard lateral lumbar interbody fusion surgery for degenerative lumbar spine disease: a retrospective radiographic propensity score-matched analysis","volume":"157","author":"Soliman","year":"2022","unstructured":"Soliman MARKhan APollina J. Comparison of prone transpsoas and standard lateral lumbar interbody fusion surgery for degenerative lumbar spine disease: a retrospective radiographic propensity score-matched analysis. World Neurosurg. 2022;157:e11-e21."},{"issue":"3","key":"bib14","series-title":"Glob Spine J","first-page":"218","article-title":"Adverse outcomes and prediction of cardiopulmonary complications in elective spine surgery","volume":"8","author":"Passias","year":"2018","unstructured":"Passias PGPoorman GWDelsole E, et al. Adverse outcomes and prediction of cardiopulmonary complications in elective spine surgery. Glob Spine J. 2018;8(3):218-223."},{"issue":"3","key":"bib15","series-title":"J Spine Surg","first-page":"331","article-title":"Prone position lateral interbody fusion\u2013a narrative review","volume":"9","author":"Patel","year":"2023","unstructured":"Patel HMFasani-Feldberg GPatel H. Prone position lateral interbody fusion\u2013a narrative review. J Spine Surg. 2023;9(3):331-341."},{"issue":"2","key":"bib16","series-title":"J Spine Surg","first-page":"201","article-title":"Analysis of single-position for revision surgery using lateral interbody fusion and pedicle screw fixation: feasibility and perioperative results","volume":"5","author":"Ziino","year":"2019","unstructured":"Ziino CArzeno ACheng I. Analysis of single-position for revision surgery using lateral interbody fusion and pedicle screw fixation: feasibility and perioperative results. J Spine Surg. 2019;5(2):201-206."},{"issue":"1","key":"bib1","series-title":"J Spine Surg","first-page":"2","article-title":"Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF","volume":"1","author":"Mobbs","year":"2015","unstructured":"Mobbs RJPhan KMalham GSeex KRao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF. J Spine Surg. 2015;1(1):2-18."},{"issue":"2","key":"bib2","series-title":"Medicina (Kaunas)","first-page":"251","article-title":"The prone lateral approach for lumbar fusion\u2014a review of the literature and case series","volume":"59","author":"Barkay","year":"2023","unstructured":"Barkay GWellington IMallozzi SSingh HMoss IL. The prone lateral approach for lumbar fusion\u2014a review of the literature and case series. Medicina (Kaunas). 2023;59(2):251."},{"issue":"7496","key":"bib3","series-title":"BMJ","first-page":"889","article-title":"A life threatening complication after colonoscopy","volume":"330","author":"Janes","year":"2005","unstructured":"Janes SEJCowan IADijkstra B. A life threatening complication after colonoscopy. BMJ. 2005;330(7496):889-890."},{"issue":"4","key":"bib4","series-title":"Eur Spine J","first-page":"800","article-title":"Incidence of vascular complications during lateral lumbar interbody fusion: an examination of the mini-open access technique","volume":"24","author":"Kueper","year":"2015","unstructured":"Kueper JFantini GAWalker BRAichmair AHughes AP. Incidence of vascular complications during lateral lumbar interbody fusion: an examination of the mini-open access technique. Eur Spine J. 2015;24(4):800-809."},{"issue":"1","key":"bib5","series-title":"Open Med (Wars)","first-page":"307","article-title":"Iatrogenic splenic injury: review of the literature and medico-legal issues","volume":"11","author":"Feola","year":"2016","unstructured":"Feola ANiola MConti A, et al. Iatrogenic splenic injury: review of the literature and medico-legal issues. Open Med (Wars). 2016;11(1):307-315."},{"issue":"2","key":"bib6","series-title":"Clin Anat N Y N","first-page":"212","article-title":"Anatomic mechanisms for splenic injury during colorectal surgery","volume":"25","author":"Merchea","year":"2012","unstructured":"Merchea ADozois EJWang JKLarson DW. Anatomic mechanisms for splenic injury during colorectal surgery. Clin Anat N Y N. 2012;25(2):212-217."},{"issue":"6","key":"bib7","series-title":"J R Coll Surg Edinb","first-page":"731","article-title":"Iatrogenic splenic injury","volume":"47","author":"Cassar","year":"2002","unstructured":"Cassar KMunro A. Iatrogenic splenic injury. J R Coll Surg Edinb. 2002;47(6):731-741."},{"issue":"3","key":"bib8","series-title":"Langenbecks Arch Chir","first-page":"207","article-title":"Der Bandapparat der Milz und seine Bedeutung bei chirurgischen Eingriffen.","volume":"371","author":"Ostermann","year":"1987","unstructured":"Ostermann PASchreiber HWLierse W. Der Bandapparat der Milz und seine Bedeutung bei chirurgischen Eingriffen.The ligament system of the spleen and its significance for surgical interventions. Langenbecks Arch Chir. 1987;371(3):207-216."},{"issue":"9","key":"bib9","series-title":"Clin Orthop Relat Res","first-page":"2271","article-title":"Case reports: splenic rupture after anterior thoracolumbar spinal fusion through a thoracoabdominal approach","volume":"466","author":"Heyworth","year":"2008","unstructured":"Heyworth BESchwab JHBoachie-Adjei OB. Case reports: splenic rupture after anterior thoracolumbar spinal fusion through a thoracoabdominal approach. Clin Orthop Relat Res. 2008;466(9):2271-2275."},{"issue":"suppl 4","key":"bib10","series-title":"Eur Spine J","first-page":"S569","article-title":"Rupture of the spleen following thoracoscopic spine surgery in a patient with chronic pancreatitis","volume":"24","author":"Bogner","year":"2015","unstructured":"Bogner RResch HMayer MLederer SOrtmaier R. Rupture of the spleen following thoracoscopic spine surgery in a patient with chronic pancreatitis. Eur Spine J. 2015;24(suppl 4):S569-S572."},{"issue":"3","key":"bib11","series-title":"J Bone Joint Surg Am","first-page":"396","article-title":"Splenic injury complicating the anterior thoracoabdominal surgical approach for scoliosis. A report of two cases","volume":"65","author":"Hodge","year":"1983","unstructured":"Hodge WADeWald RL. Splenic injury complicating the anterior thoracoabdominal surgical approach for scoliosis. A report of two cases. J Bone Joint Surg Am. 1983;65(3):396-397."},{"issue":"5","key":"bib12","series-title":"J Pediatr Orthop","first-page":"537","article-title":"Spleen rupture after surgery in Marfan syndrome scoliosis","volume":"24","author":"Christodoulou","year":"2004","unstructured":"Christodoulou AGPloumis ATerzidis IPTimiliotou KGerogianni NSpyridis C. Spleen rupture after surgery in Marfan syndrome scoliosis. J Pediatr Orthop. 2004;24(5):537-540."},{"key":"bib13","series-title":"World Neurosurg","first-page":"e11","article-title":"Comparison of prone transpsoas and standard lateral lumbar interbody fusion surgery for degenerative lumbar spine disease: a retrospective radiographic propensity score-matched analysis","volume":"157","author":"Soliman","year":"2022","unstructured":"Soliman MARKhan APollina J. Comparison of prone transpsoas and standard lateral lumbar interbody fusion surgery for degenerative lumbar spine disease: a retrospective radiographic propensity score-matched analysis. World Neurosurg. 2022;157:e11-e21."},{"issue":"3","key":"bib14","series-title":"Glob Spine J","first-page":"218","article-title":"Adverse outcomes and prediction of cardiopulmonary complications in elective spine surgery","volume":"8","author":"Passias","year":"2018","unstructured":"Passias PGPoorman GWDelsole E, et al. Adverse outcomes and prediction of cardiopulmonary complications in elective spine surgery. Glob Spine J. 2018;8(3):218-223."},{"issue":"3","key":"bib15","series-title":"J Spine Surg","first-page":"331","article-title":"Prone position lateral interbody fusion\u2013a narrative review","volume":"9","author":"Patel","year":"2023","unstructured":"Patel HMFasani-Feldberg GPatel H. Prone position lateral interbody fusion\u2013a narrative review. J Spine Surg. 2023;9(3):331-341."},{"issue":"2","key":"bib16","series-title":"J Spine Surg","first-page":"201","article-title":"Analysis of single-position for revision surgery using lateral interbody fusion and pedicle screw fixation: feasibility and perioperative results","volume":"5","author":"Ziino","year":"2019","unstructured":"Ziino CArzeno ACheng I. Analysis of single-position for revision surgery using lateral interbody fusion and pedicle screw fixation: feasibility and perioperative results. J Spine Surg. 2019;5(2):201-206."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/8\/3\/article-CASE23639.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/8\/3\/article-CASE23639.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/8\/3\/article-CASE23639.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:55:23Z","timestamp":1769687723000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/8\/3\/article-CASE23639.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":32,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/case23639","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,15]]}}}