How to treat jatrogenic ureteral injury after posterior spinal surgery? Case report and review of literature

Introduction: Entry into the retroperitoneal space during open posterior spinal surgery introduces the rare possibility of iatrogenic ureteral injury.

Case presentation: We describe a case of ureteral injury after spinal surgery in a 49-year-old female with persistent lumbar pain and high fever 2 weeks after spinal surgery. After admission to the urology department, a computer tomography scan was performed and revealed right-side hydronephrosis grade III and large retroperitoneal fluid collection. After radiological confirmation of right ureteral injury, a ureteral stent was placed, but 4 weeks later, ureteral stricture was confirmed on antegrade pyelography. Therefore, surgical ureteroplasty was indicated 2 months after initial admission to the urology department. Six weeks later, the stent was removed, and intravenous pyelography revealed a normal ureteral passage.

Conclusion: There should be a low threshold for ureteral injuries after spinal cord surgery in patients with high fever and elevated blood creatinine levels.