Endovascular embolization of iatrogenic vertebral artery injury during anterior cervical spine surgery: report of two cases and review of the literature
| Autor: | Hyoung-Jun Kwak, Jung-Kil Lee, Jae-Hyoo Kim, Kyung-Sub Moon, Soo-Han Kim, Sung-Pil Joo, Jeong-Wook Choi, Yeon-Seong Kim |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Decompression Vertebral artery medicine.medical_treatment Iatrogenic Disease Wounds Penetrating Pseudoaneurysm Aneurysm medicine.artery Cervical spondylosis Medicine Humans Surgical Wound Infection Orthopedics and Sports Medicine Orthopedic Procedures Embolization Intervertebral foramen Device Removal Vertebral Artery medicine.diagnostic_test business.industry Middle Aged medicine.disease Embolization Therapeutic Internal Fixators Surgery Radiography medicine.anatomical_structure Spinal Fusion Angiography Cervical Vertebrae Female Neurology (clinical) Radiology business Aneurysm False |
| Zdroj: | Spine. 31(23) |
| ISSN: | 1528-1159 |
| Popis: | Study design Case description. Objectives To report 2 cases of vertebral artery injury (VAI) during anterior cervical decompression surgery and review the pertinent medical literature. Summary of background data The incidence of VAI during an anterior surgical approach to the cervical spine is rare but potentially lethal. The spine surgeon should be aware of the detailed surgical anatomy and be prepared to manage an inadvertent injury to the vertebral artery. Methods In the first case presented, infection was the cause of VAI. During aggressive irrigation and pus drainage, massive bleeding was encountered. For the second case, the vertebral artery was injured during decompression of cervical spondylosis while drilling the neural foramen. Intraoperative direct packing with hemostatic agents provided effective control of hemorrhage. Results Ten days after surgery, sudden neck swelling and mental deterioration occurred because of rebleeding from a pseudoaneurysm in the first case. In the second case, a pseudoaneurysm was detected by angiography, obtained 4 days after surgery. Both pseudoaneurysms were successfully occluded by an endovascular technique without any neurologic sequelae. Conclusions In case of bleeding control by hemostatic packing, there remains a risk of delayed hemorrhage from pseudoaneurysm. Postoperative vertebral angiography is helpful to avoid life-threatening complications. Endovascular treatment can be a good alternative in the treatment of VAI. |
| Databáze: | OpenAIRE |
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