U.S. Department of Defense


Date of this Version



Published in The Spine Journal 11 (2011) 684–685


The patient was a 69-year-old female who had previously undergone a T10-ilium posterior spinal fusion for lumbar scoliosis and spinal stenosis. She presented 2 years after the index procedure for new complaints of low back pain and midthoracic pain, and a feeling of ‘‘tipping over.’’ Scoliosis survey and computed tomography (CT) revealed proximal junctional kyphosis with cephalad degeneration and pseudarthrosis at L5–S1 and L3–L4. She subsequently underwent anterior lumbar interbody fusion from L3 sacrum and revision posterior spinal fusion from T3 ilium the same day. She recovered uneventfully until she returned for follow-up approximately 3 weeks after surgery. At that time, she complained of a distention that manifested as her pants and clothing were not fitting properly. On examination, she exhibited a distended abdomen and fluid wave was percussed.