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Nightmare of lumbar disc surgery: iliac artery injury
Murat Döşoğlu1, Merih Iş, Mevlüt Pehlivan
1Department of Neurosurgery, Düzce Medical School, Abant Izzet Baysal University, Düzce, Turkey. mdosoglu@dtip.edu.tr
Insights
Pelvic vessel injuries during lumbar disc surgery are rare but severe, potentially causing life-threatening bleeding or late vascular issues. Prompt recognition and repair of these intra-operative injuries are crucial for patient survival.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Anatomy
Background:
- Lumbar disc surgery, while common, carries risks of rare but serious intra-operative complications.
- Injuries to pelvic blood vessels during these procedures can lead to significant morbidity and mortality.
Observation:
- This report details a case of major vascular injury identified during a posterior lumbar discectomy.
- The injury involved pelvic vessels, a known but infrequent complication of this spinal surgery.
Findings:
- Immediate intra-operative recognition of the vascular injury was achieved.
- The identified major vascular injury was successfully repaired during the same surgical procedure.
Implications:
- Surgeons performing lumbar disc surgery must maintain high vigilance for potential pelvic vascular injuries.
- Awareness and prompt management of these vascular complications are critical for preventing catastrophic outcomes.
- This case underscores the importance of anatomical knowledge and preparedness for vascular emergencies in spinal surgery.
Abstract:
Intra-operative injuries of pelvic vessels are quite infrequent but serious complications of lumbar disc surgery. Injury may cause laceration of the vessel with acute life threatening retroperitoneal haemorrhage, formation of pseudoaneurysms or arteriovenous fistulae in the late phase. It is important for surgeons to be aware of these potentially fatal complications. Authors reported a case of major vascular injury recognised intra-operatively during posterior lumbar discectomy and repaired immediately.
