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

Academic Editor: Graham Pawelec

Front. Biosci. (Landmark Ed) 2021, 26(12), 1760–1768; https://doi.org/10.52586/5067
Submitted: 20 October 2021 | Revised: 6 December 2021 | Accepted: 8 December 2021 | Published: 30 December 2021
(This article belongs to the Special Issue Innovation in Forensic Pathology and Forensic Genetics)
Copyright: © 2021 The Author(s). Published by BRI.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

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.

Keywords
Fat embolism syndrome
Spine surgery
Oil red
Immunohistochemistry
Autopsy
Liability
Claims
Accountability
Figures
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