Psoas hematoma formation after violation of the intertransverse plane during posterior spinal surgery for adolescent idiopathic scoliosis

Özet

Psoas hematoma is a rare yet potentially serious complication following posterior spinal surgery as it is apossible nidus for infection. We present a case of psoas hematoma formation following scoliosis surgerydue to intraoperative violation of the intertransverse plane. A 13-year-old female patient with adolescentidiopathic scoliosis underwent a posterior deformity correction and instrumented fusion which wascomplicated with intraoperative inadvertent violation of the intertransverse plane during dissection ofthe posterolateral gutter leading to a unilateral psoas hematoma. She experienced abdominal pain and aCT scan confirmed the presence of a psoas hematoma. Antibiotic coverage was provided in view ofpositive blood culture of Bacillus species to avoid infective seeding of the hematoma. Resolution of thehematoma was observed on the reassessment CT one month postoperatively. It is not uncommon forpatients to develop atrophic transverse processes due to spinal deformity. This may cause difficulties inidentification of the anatomy intraoperatively and thus, extra caution should be exercised duringdissection to prevent violation of the intertransverse plane and subsequent psoas hematomacomplication.