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Related Experiment Videos

Postoperative bilateral vertebral artery dissection: a case report.

C Manaouil1, M Graser, J Delcour

  • 1Department of Forensic Medicine, CHU Amiens, France.

Journal of Clinical Forensic Medicine
|July 28, 2004
PubMed
Summary

Cervical spine surgery can lead to rare but severe complications. This case highlights a fatal instance of bilateral vertebral artery dissection and thrombosis following a C5-C6 and C6-C7 discectomy, resulting in brainstem and cerebellar infarction.

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Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Neurology

Background:

  • Cervical spine surgery is increasingly common due to advancements in medical imaging and surgical techniques.
  • While generally safe, complications can arise, necessitating careful consideration of potential risks.
  • Vertebral artery dissection is a recognized, albeit infrequent, complication associated with cervical spine procedures.

Purpose of the Study:

  • To report a rare case of postoperative bilateral vertebral artery dissection and thrombosis.
  • To investigate the causal link between cervical spine surgery and this severe complication.
  • To emphasize the importance of recognizing and managing potential vascular injuries during cervical procedures.

Main Methods:

  • A case report detailing a 58-year-old female patient who underwent discectomy at C5-C6 and C6-C7 with intersomatic cage placement.

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  • Postoperative diagnosis using supra-aortic echography and CT scan to identify vertebral artery thrombosis and ischemic brain lesions.
  • Autopsy to confirm the cause of death and its relation to the surgical intervention.

    • Main Results:

    • The patient developed irreversible coma post-surgery.
    • Diagnostic imaging revealed bilateral vertebral artery thrombosis and subsequent ischemic brainstem and cerebellar lesions.
    • Autopsy confirmed that the cause of death was ischemic brain injury secondary to bilateral traumatic vertebral artery occlusion from the surgery.

    Conclusions:

    • Bilateral vertebral artery dissection and thrombosis can be a catastrophic complication of cervical spine surgery.
    • Surgical manipulation during discectomy and intersomatic cage placement may lead to traumatic vertebral artery injury.
    • This case underscores the critical need for vigilance regarding vascular complications in cervical spine surgery and highlights a fatal outcome due to surgical-induced vertebral artery occlusion.