Gossypiboma Encountered 40 Years after Lumbar Partial Laminectomy - A Case Report -

Dong Jun Kim; Gyu Min Kong; Dong Hoon Yang; Sung Hwan Kim; Sang Ho Moon

doi:10.7469/JKSS.2009.16.1.54

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Kim, Kong, Yang, Kim, and Moon: Gossypiboma Encountered 40 Years after Lumbar Partial Laminectomy - A Case Report -

Case Report

Journal of Korean Spine Surg 2009;16(1):54-58.

Published online: 18 January 2009

DOI: https://doi.org/10.7469/JKSS.2009.16.1.54

Gossypiboma Encountered 40 Years after Lumbar Partial Laminectomy - A Case Report -

Dong Jun Kim, M.D., Gyu Min Kong, M.D., Dong Hoon Yang, M.D.^#, Sung Hwan Kim, M.D., Sang Ho Moon, M.D.^§,

Handong University Sunlin Hospital, Pohang, Korea

^{^#}Department of Orthopedic Surgery and Neurosurgery

^{^§}Department of Orthopedic Surgery, Wallace Memorial Baptist Hospital, Busan, Korea

Address reprint requests to Sang Ho Moon, M.D. Department of Orthopedic Surgery, Wallace Memorial Baptist Hospital 374-75 Namsan-dong, Geumjung-gu, Busan, 609-728, Korea Tel: 82-51-580-1273, Fax: 82-51-583-2568, E-mail: msh124@paran.com

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gossypiboma is a mass within body consisting of a cotton matrix surrounded by a foreign-body reaction. Some patients may remain asymptomatic, while others develop early persistent infected conditions. Gossypiboma should be included in a differential diagnosis of a paravertebral mass in postoperative patients, and a thorough and a careful inspection of the surgical field before closure must be performed by surgeons to avoid the complications of gossypiboma even when there are correct counts. We present a patient in whom a gossypiboma at the 4th lumbar spine was encountered 40 years after a partial laminectomy with no subjective symptoms.

Keywords: Spine, Gossypiboma

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Fig. 1.

A 60-year-old man who underwent left L3 and L4 partial laminectomy 40 years ago. Preoperative (A) anteroposterior and (B) lateral radiographs show left laminectomy state of L3 and L4.

Fig. 2.

(A) Sagittal and (B) axial T1 weighted images show paravertebral mass with an intermediate signal intensity (arrows). (C) Sagittal and (D) axial T2 weighted images show a high signal intensity within the center of the lesion and a low signal intensity within the peripheral rim (arrows). (E) Sagittal and (F) axial enhanced images reveal strong enhancement of the peripheral rim of the lesion (arrows).

Fig. 3.

Postoperative (A) anteroposterior and (B) lateral radiographs show posterior lumbar intervertebral fusion and posterolateral fusion state of L3 and L4.

Fig. 4. (A)

Foreign materials area scattered in the sclerotic stroma with mild infiltration of lymphocytes. (B) Multiple microcalcifications are present (Hematoxylin & eosin stain, × 200).

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