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Updated: Aug 7, 2026
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Published on: September 8, 2023
Left internal iliac artery and vein tear during microendoscopic lumbar discectomy - a case report
Chung-Pei Chang1, Wei-Shih Lee, Shu-Chuan Lee
1Department of Anaesthesiology, Show Chwan Memorial Hospital, Changua, Taiwan, ROC.
Abstract:
As minimally invasive techniques have gained popularity across surgical specialties, microendoscopic discectomy has been hailed as one of the newest and best methods for disc removal. Although problems are unusual and infrequent, the complications that can be associated with this procedure should be realized. Iatrogenic major vascular injury is a rare but serious complication during microendoscopic discectomy, and early detection is difficult due to the surgical positions, the specific anatomy of the spine, and the subtle changes of signs and symptoms the patient manifests. Here, we present a female patient who suffered from left internal iliac artery and vein tear during microendoscopic lumbar discectomy. We conclude that both surgeons and anesthesiologists should be aware of the possibility of this complication during surgery. When this complication occurs, it is vitally important that the correct crisis resolution protocols, such as proper massive transfusion algorithm and successful surgical interventions, be applied immediately during the critical period.
Insights
Microendoscopic discectomy, a minimally invasive spine surgery, can rarely lead to major vascular injury. Early detection and immediate intervention are crucial for managing this serious complication.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Minimally Invasive Spine Surgery
Background:
- Microendoscopic discectomy is a popular minimally invasive technique for disc removal.
- While generally safe, rare but serious complications can occur.
Observation:
- Iatrogenic major vascular injury is a rare complication during microendoscopic discectomy.
- Early detection is challenging due to patient positioning, spinal anatomy, and subtle clinical signs.
- A case of left internal iliac artery and vein tear during lumbar discectomy is presented.
Findings:
- The case highlights the potential for severe vascular damage during the procedure.
- Prompt recognition and management are critical for patient outcomes.
Implications:
- Surgeons and anesthesiologists must be aware of this potential complication.
- Established crisis resolution protocols, including massive transfusion and surgical intervention, are vital for immediate management.
