IMR Press / FBL / Volume 26 / Issue 12 / DOI: 10.52586/5067
Open Access Case Report
Spine surgery and fat embolism syndrome. Defining the boundaries of medical accountability by hospital autopsy
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1 Department of Medicine, Surgery and Health Sciences, University of Trieste, 34149 Trieste, Italy
2 Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
3 Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy
*Correspondence: (Stefano D’Errico)
Academic Editor: Graham Pawelec
Front. Biosci. (Landmark Ed) 2021, 26(12), 1760–1768;
Submitted: 20 October 2021 | Revised: 6 December 2021 | Accepted: 8 December 2021 | Published: 30 December 2021
Copyright: © 2021 The Author(s). Published by BRI.
This is an open access article under the CC BY 4.0 license (

Background: Fat Embolism Syndrome (FES) is a clinical condition characterized by neurological, respiratory, hematological and cutaneous manifestations. Fatal FES has been described as a rare complication during or after spinal elective surgery. The investigation of the cause of death in fatalities related with spine surgery should be mandatory to exclude or confirm fat embolism; a detailed methodological approach to the body in these cases suggests to provide a cautious dissection of surgical site and collection of samples to detect embolized fat globules in vessels. Methods: Two fatal cases of fat embolism syndrome after posterior spinal fusion are presented. Conclusions: A complete post mortem examination by means of histochemical and immunohistochemical analysis explained the cause of death and prevented medical malpractice litigation.

Fat embolism syndrome
Spine surgery
Oil red
Fig. 1.
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