Splenic Rupture After Minimal Invasive Lateral Retropleural Corpectomy

Retropleural minimal invasive approach to the thoracolumbar junction has become more popular in the last decade both for degenerative and traumatic spine surgery as it marries the advantages of direct vision typical of open surgery and the philosophy of tissue sparing which characterizes the thoracoscopic approach. Nevertheless, as with the just mentioned techniques, this approach also requires the caudal displacement of the diaphragm with the organs below including the spleen. The authors report one case of postoperative spleen disruption following a retropleural minimal invasive approach in a patient with an underlying grade II spleen lesion occurred 8 days before and considered safe by the general surgeon. We conclude that even negligible spleen injuries must be considered an absolute contraindication to thoracolumbar junction lateral approach even with minimal invasive techniques.