[Common iliac artery false aneurysm as complication of lumbar disc hernia surgery. Case report]

Surgery for discogenic disease of lumbar region is a challenging and diverse field. The significance of complications in disc surgery arises from the possibility that failure of primary treatment may lead to a permanently disable patient. The most common iatrogenic lesions in the posterior approach to lumbar disc herniation are neurologic, vascular, enteric, ureteral, and sexual dysfunction. Abramovitz reports that vascular complications of the posterior approach occur in at least 0.1% of cases. The vascular complications may present during surgery as severe bleeding leading to hypotension. The most common late complication is arteriovenous fistula followed by false aneurysms. We describe the case of a 39 year-old woman who was operated on for a lumbar disc herniation in other hospital. She came to us with a persistent pain in lumbar area. A MRI scan of lumbosacral region revealed a paravertebral lesion suggesting abscess. An angiography was performed and showed a false aneurysm of left common iliac artery, which was surgically treated successfully. We discuss the mechanisms of lesion and precautions against vascular ones during lumbar disc surgery.