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Far lateral disc excision at L5-S1 complicated by iliolumbar artery incursion: case report
1Department of Neurosurgery, Brown University School of Medicine, Providence, Rhode Island.
Neurosurgery
|June 1, 2001
Summary
Paramedial approaches to far lateral discs carry risks. Surgeons must evaluate L5-S1 magnetic resonance imaging for iliolumbar artery variants to prevent hemorrhage during extraforaminal disc surgery.
Area of Science:
- Neurosurgery
- Vascular Anatomy
Background:
- Paramedial approaches to far lateral discs at L5-S1 offer surgical advantages.
- These approaches may increase proximity to internal iliac artery branches.
Observation:
- A patient with L5 radiculopathy underwent extraforaminal disc surgery at L5-S1.
- Hemorrhage occurred from an iliolumbar artery during disc fragment removal.
Findings:
- The bleeding originated from a branch of the internal iliac artery.
- Emergency laparotomy was required to control the arterial hemorrhage.
Implications:
- Preoperative magnetic resonance imaging evaluation is crucial for identifying iliolumbar artery variants near the L5-S1 disc space.
- Awareness of these vascular variants can prevent intraoperative complications during extraforaminal disc surgery.