{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:53:55Z","timestamp":1769727235968,"version":"3.49.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"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":[[2024,7,29]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Chylous fluid leakage following spinal surgery is a rare and potentially difficult-to-manage complication that can lead to wound complications, pain, or nutritional deficiencies. Although the thoracic duct is localized near the thoracic spine, reports of thoracic duct injuries secondary to posterior thoracic spine surgery are rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors present the case of a 57-year-old male with a known history of metastatic renal cell carcinoma to the thoracic spine who had undergone a thoracolumbar fusion with thoracic corpectomy and presented with concern for a chyle leak almost a year after his surgery. The patient had a complicated oncological history and underwent decompression and fusion to treat his significant thoracic metastatic disease. A year later, he presented with back pain and a significant fluid collection at the surgical site, which was drained and found to be consistent with chyle. The patient was treated conservatively, and imaging of the thoracic duct a few months later demonstrated no direct injury, likely indicating either transient injury or potential obstruction of the thoracic duct from metastatic disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case demonstrates a rare, potential complication when treating extensive thoracic metastatic disease as well as the workup and potential treatments when facing thoracic duct injury.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24280\">https:\/\/thejns.org\/doi\/10.3171\/CASE24280<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24280","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T02:58:58Z","timestamp":1722221938000},"source":"Crossref","is-referenced-by-count":2,"title":["Delayed chylous fluid leakage at the surgical site following thoracic corpectomy via a lateral extracavitary approach: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Randall W","family":"Treffy","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Bakhaidar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin"},{"name":"Department of Surgery, Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saman","family":"Shabani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"J Neurosurg Spine","first-page":"722","article-title":"Lymphocele after anterior lumbar interbody fusion: a review of 1322 patients","volume":"35","author":"Scheer","year":"2021","unstructured":"Scheer JKHaddad AFChan AK, et al. Lymphocele after anterior lumbar interbody fusion: a review of 1322 patients. J Neurosurg Spine. 2021;35(6):722-728."},{"issue":"1","key":"bib2","series-title":"J Neurosurg","first-page":"151","article-title":"Thoracic duct injury during anterior cervical discectomy: a rare complication. Case report","volume":"88","author":"Hart","year":"1998","unstructured":"Hart AKEGreinwald JHShaffrey CIPostma GN. Thoracic duct injury during anterior cervical discectomy: a rare complication. Case report. J Neurosurg. 1998;88(1):151-154."},{"issue":"1","key":"bib3","series-title":"Glob Spine J","first-page":"115S","article-title":"Thoracic duct injury following cervical spine surgery: a multicenter retrospective review","volume":"7","author":"Derakhshan","year":"2017","unstructured":"Derakhshan ALubelski DSteinmetz MP, et al. Thoracic duct injury following cervical spine surgery: a multicenter retrospective review. Glob Spine J. 2017;7(1suppl):115S-119S."},{"issue":"5","key":"bib4","series-title":"J Neurosurg Spine","first-page":"562","article-title":"Chyloretroperitoneum following anterior spinal deformity correction: case report","volume":"7","author":"Upadhyaya","year":"2007","unstructured":"Upadhyaya CDPark PLa Marca F. Chyloretroperitoneum following anterior spinal deformity correction: case report. J Neurosurg Spine. 2007;7(5):562-565."},{"issue":"5","key":"bib5","series-title":"Cureus","first-page":"e1231","article-title":"Delayed chyle leak following anterior cervical spinal surgery: a case report and management algorithm","volume":"9","author":"Mueller","year":"2017","unstructured":"Mueller KSyed HRRhee JWNair MN. Delayed chyle leak following anterior cervical spinal surgery: a case report and management algorithm. Cureus. 2017;9(5):e1231."},{"issue":"5","key":"bib6","series-title":"J Neurosurg Spine","first-page":"415","article-title":"Chyloretroperitoneum following anterior spinal surgery","volume":"17","author":"Hussain","year":"2012","unstructured":"Hussain NSHanscom DOskouian RJ. Chyloretroperitoneum following anterior spinal surgery. J Neurosurg Spine. 2012;17(5):415-421."},{"issue":"23","key":"bib7","series-title":"Spine","first-page":"2766","article-title":"Chylous leakage after circumferential thoracolumbar fusion for correction of kyphosis resulting from fracture: report of three cases","volume":"22","author":"Nagai","year":"1997","unstructured":"Nagai HShimizu KShikata J, et al. Chylous leakage after circumferential thoracolumbar fusion for correction of kyphosis resulting from fracture: report of three cases. Spine. 1997;22(23):2766-2769."},{"issue":"suppl","key":"bib8","series-title":"Eur Spine J","first-page":"332","article-title":"Spontaneous healing of retroperitoneal chylous leakage following anterior lumbar spinal surgery: a case report and literature review","volume":"16","author":"Su","year":"2007","unstructured":"Su ICChen CM. Spontaneous healing of retroperitoneal chylous leakage following anterior lumbar spinal surgery: a case report and literature review. Eur Spine J. 2007;16(suppl3):332-337."},{"issue":"22","key":"bib9","series-title":"Spine","first-page":"E852","article-title":"Evaluation and management of abdominal lymphoceles after anterior lumbar spine surgery","volume":"33","author":"Jagannathan","year":"2008","unstructured":"Jagannathan JAnton TBaweja HKleiner DEPeeler BArlet V. Evaluation and management of abdominal lymphoceles after anterior lumbar spine surgery. Spine. 2008;33(22):E852-E857."},{"issue":"5","key":"bib10","series-title":"J Trauma Acute Care Surg","first-page":"e140","article-title":"Chylothorax in spine fractures: a rarely reported complication? Literature review with an example case","volume":"89","author":"Lofrese","year":"2020","unstructured":"Lofrese GCultrera FVisani J, et al. Chylothorax in spine fractures: a rarely reported complication? Literature review with an example case. J Trauma Acute Care Surg. 2020;89(5):e140-e146."},{"issue":"1","key":"bib11","series-title":"J Orthop Rep","first-page":"100121","article-title":"Thoracic duct injury after AO C thoracic spine fracture: a case report","volume":"2","author":"Curtin","year":"2023","unstructured":"Curtin PBMitchell BJHall RR IIIStauff MP. Thoracic duct injury after AO C thoracic spine fracture: a case report. J Orthop Rep. 2023;2(1):100121."},{"issue":"2","key":"bib12","series-title":"Spine","first-page":"E32","article-title":"Chylous leakage after thoracolumbar fracture may cause paraplegia","volume":"29","author":"von Knoch","year":"2004","unstructured":"von Knoch MMichiels IMueller SSiahkamary L. Chylous leakage after thoracolumbar fracture may cause paraplegia. Spine. 2004;29(2):E32-E34."},{"issue":"1","key":"bib13","series-title":"Surg Today","first-page":"56","article-title":"Late-onset chylothorax after blunt chest trauma at an interval of 20 years: report of a case","volume":"38","author":"Kamiyoshihara","year":"2008","unstructured":"Kamiyoshihara MIbe TKakegawa SSato KTakise ATakeyoshi I. Late-onset chylothorax after blunt chest trauma at an interval of 20 years: report of a case. Surg Today. 2008;38(1):56-58."},{"issue":"2","key":"bib14","series-title":"Mayo Clin Proc","first-page":"129","article-title":"Pleural fluid characteristics of chylothorax","volume":"84","author":"Maldonado","year":"2009","unstructured":"Maldonado FHawkins FJDaniels CEDoerr CHDecker PARyu JH. Pleural fluid characteristics of chylothorax. Mayo Clin Proc. 2009;84(2):129-133."},{"issue":"8","key":"bib15","series-title":"Am J Gastroenterol","first-page":"1896","article-title":"Chylous ascites","volume":"97","author":"C\u00e1rdenas","year":"2002","unstructured":"C\u00e1rdenas AChopra S. Chylous ascites. Am J Gastroenterol. 2002;97(8):1896-1900."},{"issue":"2","key":"bib16","series-title":"Indian J Nucl Med","first-page":"177","article-title":"Lymphoscintigraphy combined with single-photon emission computed tomography-computed tomography (SPECT-CT): a very effective imaging approach for identification of the site of leak in postoperative chylothorax","volume":"30","author":"Das","year":"2015","unstructured":"Das JThambudorai RRay S. Lymphoscintigraphy combined with single-photon emission computed tomography-computed tomography (SPECT-CT): a very effective imaging approach for identification of the site of leak in postoperative chylothorax. Indian J Nucl Med. 2015;30(2):177-179."},{"issue":"6","key":"bib17","series-title":"RadioGraphics","first-page":"1554","article-title":"Nontraumatic chylothorax: nonenhanced MR lymphography","volume":"40","author":"Cholet","year":"2020","unstructured":"Cholet CDelalandre CMonnier-Cholley LLe Pimpec-Barthes FEl Mouhadi SArriv\u00e9 L. Nontraumatic chylothorax: nonenhanced MR lymphography. RadioGraphics. 2020;40(6):1554-1573."},{"key":"bib18","series-title":"Respir Med Case Rep","first-page":"260","article-title":"Chylothorax after spinal fusion surgery: a case report and literature review","volume":"26","author":"Toriyama","year":"2019","unstructured":"Toriyama KKokuho NYajima C, et al. Chylothorax after spinal fusion surgery: a case report and literature review. Respir Med Case Rep. 2019;26:260-264."},{"issue":"6","key":"bib19","series-title":"Korean J Radiol","first-page":"724","article-title":"Lymphangiography to treat postoperative lymphatic leakage: a technical review","volume":"15","author":"Lee","year":"2014","unstructured":"Lee EWShin JHKo HKPark JKim SHSung KB. Lymphangiography to treat postoperative lymphatic leakage: a technical review. Korean J Radiol. 2014;15(6):724-732."},{"issue":"5","key":"bib20","series-title":"J Neurosurg Spine","first-page":"566","article-title":"Lymphocele formation after anterior lumbar interbody fusion at L4\u20135: case report","volume":"7","author":"Pee","year":"2007","unstructured":"Pee YHKim KJChoi YGJeon SHPark JDLee SH. Lymphocele formation after anterior lumbar interbody fusion at L4\u20135: case report. J Neurosurg Spine. 2007;7(5):566-570."},{"issue":"6","key":"bib1","series-title":"J Neurosurg Spine","first-page":"722","article-title":"Lymphocele after anterior lumbar interbody fusion: a review of 1322 patients","volume":"35","author":"Scheer","year":"2021","unstructured":"Scheer JKHaddad AFChan AK, et al. Lymphocele after anterior lumbar interbody fusion: a review of 1322 patients. J Neurosurg Spine. 2021;35(6):722-728."},{"issue":"1","key":"bib2","series-title":"J Neurosurg","first-page":"151","article-title":"Thoracic duct injury during anterior cervical discectomy: a rare complication. Case report","volume":"88","author":"Hart","year":"1998","unstructured":"Hart AKEGreinwald JHShaffrey CIPostma GN. Thoracic duct injury during anterior cervical discectomy: a rare complication. Case report. J Neurosurg. 1998;88(1):151-154."},{"issue":"1","key":"bib3","series-title":"Glob Spine J","first-page":"115S","article-title":"Thoracic duct injury following cervical spine surgery: a multicenter retrospective review","volume":"7","author":"Derakhshan","year":"2017","unstructured":"Derakhshan ALubelski DSteinmetz MP, et al. Thoracic duct injury following cervical spine surgery: a multicenter retrospective review. Glob Spine J. 2017;7(1suppl):115S-119S."},{"issue":"5","key":"bib4","series-title":"J Neurosurg Spine","first-page":"562","article-title":"Chyloretroperitoneum following anterior spinal deformity correction: case report","volume":"7","author":"Upadhyaya","year":"2007","unstructured":"Upadhyaya CDPark PLa Marca F. Chyloretroperitoneum following anterior spinal deformity correction: case report. J Neurosurg Spine. 2007;7(5):562-565."},{"issue":"5","key":"bib5","series-title":"Cureus","first-page":"e1231","article-title":"Delayed chyle leak following anterior cervical spinal surgery: a case report and management algorithm","volume":"9","author":"Mueller","year":"2017","unstructured":"Mueller KSyed HRRhee JWNair MN. Delayed chyle leak following anterior cervical spinal surgery: a case report and management algorithm. Cureus. 2017;9(5):e1231."},{"issue":"5","key":"bib6","series-title":"J Neurosurg Spine","first-page":"415","article-title":"Chyloretroperitoneum following anterior spinal surgery","volume":"17","author":"Hussain","year":"2012","unstructured":"Hussain NSHanscom DOskouian RJ. Chyloretroperitoneum following anterior spinal surgery. J Neurosurg Spine. 2012;17(5):415-421."},{"issue":"23","key":"bib7","series-title":"Spine","first-page":"2766","article-title":"Chylous leakage after circumferential thoracolumbar fusion for correction of kyphosis resulting from fracture: report of three cases","volume":"22","author":"Nagai","year":"1997","unstructured":"Nagai HShimizu KShikata J, et al. Chylous leakage after circumferential thoracolumbar fusion for correction of kyphosis resulting from fracture: report of three cases. Spine. 1997;22(23):2766-2769."},{"issue":"suppl","key":"bib8","series-title":"Eur Spine J","first-page":"332","article-title":"Spontaneous healing of retroperitoneal chylous leakage following anterior lumbar spinal surgery: a case report and literature review","volume":"16","author":"Su","year":"2007","unstructured":"Su ICChen CM. Spontaneous healing of retroperitoneal chylous leakage following anterior lumbar spinal surgery: a case report and literature review. Eur Spine J. 2007;16(suppl3):332-337."},{"issue":"22","key":"bib9","series-title":"Spine","first-page":"E852","article-title":"Evaluation and management of abdominal lymphoceles after anterior lumbar spine surgery","volume":"33","author":"Jagannathan","year":"2008","unstructured":"Jagannathan JAnton TBaweja HKleiner DEPeeler BArlet V. Evaluation and management of abdominal lymphoceles after anterior lumbar spine surgery. Spine. 2008;33(22):E852-E857."},{"issue":"5","key":"bib10","series-title":"J Trauma Acute Care Surg","first-page":"e140","article-title":"Chylothorax in spine fractures: a rarely reported complication? Literature review with an example case","volume":"89","author":"Lofrese","year":"2020","unstructured":"Lofrese GCultrera FVisani J, et al. Chylothorax in spine fractures: a rarely reported complication? Literature review with an example case. J Trauma Acute Care Surg. 2020;89(5):e140-e146."},{"issue":"1","key":"bib11","series-title":"J Orthop Rep","first-page":"100121","article-title":"Thoracic duct injury after AO C thoracic spine fracture: a case report","volume":"2","author":"Curtin","year":"2023","unstructured":"Curtin PBMitchell BJHall RR IIIStauff MP. Thoracic duct injury after AO C thoracic spine fracture: a case report. J Orthop Rep. 2023;2(1):100121."},{"issue":"2","key":"bib12","series-title":"Spine","first-page":"E32","article-title":"Chylous leakage after thoracolumbar fracture may cause paraplegia","volume":"29","author":"von Knoch","year":"2004","unstructured":"von Knoch MMichiels IMueller SSiahkamary L. Chylous leakage after thoracolumbar fracture may cause paraplegia. Spine. 2004;29(2):E32-E34."},{"issue":"1","key":"bib13","series-title":"Surg Today","first-page":"56","article-title":"Late-onset chylothorax after blunt chest trauma at an interval of 20 years: report of a case","volume":"38","author":"Kamiyoshihara","year":"2008","unstructured":"Kamiyoshihara MIbe TKakegawa SSato KTakise ATakeyoshi I. Late-onset chylothorax after blunt chest trauma at an interval of 20 years: report of a case. Surg Today. 2008;38(1):56-58."},{"issue":"2","key":"bib14","series-title":"Mayo Clin Proc","first-page":"129","article-title":"Pleural fluid characteristics of chylothorax","volume":"84","author":"Maldonado","year":"2009","unstructured":"Maldonado FHawkins FJDaniels CEDoerr CHDecker PARyu JH. Pleural fluid characteristics of chylothorax. Mayo Clin Proc. 2009;84(2):129-133."},{"issue":"8","key":"bib15","series-title":"Am J Gastroenterol","first-page":"1896","article-title":"Chylous ascites","volume":"97","author":"C\u00e1rdenas","year":"2002","unstructured":"C\u00e1rdenas AChopra S. Chylous ascites. Am J Gastroenterol. 2002;97(8):1896-1900."},{"issue":"2","key":"bib16","series-title":"Indian J Nucl Med","first-page":"177","article-title":"Lymphoscintigraphy combined with single-photon emission computed tomography-computed tomography (SPECT-CT): a very effective imaging approach for identification of the site of leak in postoperative chylothorax","volume":"30","author":"Das","year":"2015","unstructured":"Das JThambudorai RRay S. Lymphoscintigraphy combined with single-photon emission computed tomography-computed tomography (SPECT-CT): a very effective imaging approach for identification of the site of leak in postoperative chylothorax. Indian J Nucl Med. 2015;30(2):177-179."},{"issue":"6","key":"bib17","series-title":"RadioGraphics","first-page":"1554","article-title":"Nontraumatic chylothorax: nonenhanced MR lymphography","volume":"40","author":"Cholet","year":"2020","unstructured":"Cholet CDelalandre CMonnier-Cholley LLe Pimpec-Barthes FEl Mouhadi SArriv\u00e9 L. Nontraumatic chylothorax: nonenhanced MR lymphography. RadioGraphics. 2020;40(6):1554-1573."},{"key":"bib18","series-title":"Respir Med Case Rep","first-page":"260","article-title":"Chylothorax after spinal fusion surgery: a case report and literature review","volume":"26","author":"Toriyama","year":"2019","unstructured":"Toriyama KKokuho NYajima C, et al. Chylothorax after spinal fusion surgery: a case report and literature review. Respir Med Case Rep. 2019;26:260-264."},{"issue":"6","key":"bib19","series-title":"Korean J Radiol","first-page":"724","article-title":"Lymphangiography to treat postoperative lymphatic leakage: a technical review","volume":"15","author":"Lee","year":"2014","unstructured":"Lee EWShin JHKo HKPark JKim SHSung KB. Lymphangiography to treat postoperative lymphatic leakage: a technical review. Korean J Radiol. 2014;15(6):724-732."},{"issue":"5","key":"bib20","series-title":"J Neurosurg Spine","first-page":"566","article-title":"Lymphocele formation after anterior lumbar interbody fusion at L4\u20135: case report","volume":"7","author":"Pee","year":"2007","unstructured":"Pee YHKim KJChoi YGJeon SHPark JDLee SH. Lymphocele formation after anterior lumbar interbody fusion at L4\u20135: case report. 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