Abdominal aortic injury due to lumbar disc surgery: A case report

Complications arising from lumbar intervertebral disc surgery are rare but fatal. Major vascular injury is one complication that may end in death unless it is diagnosed and treated immediately. Herein we report an abdominal aortic injury due to L3-L4 intervertebral disc surgery that was treated successfully and discuss it in light of current literature. Diagnosis and treatment of an abdominal aortic injury in a 31-year-old male patient operated on for L3-L4 intervertebral disc degeneration is discussed. Interestingly, in spite of abdominal aortic injury this particular patient was hemodynamically stable. The diagnosis was made 12 hours after disc surgery and laparotomy was performed immediately. As the injury in the aorta was large and had irregular margins, it could not be repaired with primary repair but an end-to-end anastomosis with partial resection was performed. In lumbar intervertebral disc hernia surgery, peroperative hemodynamic instability should raise suspicion of major vascular injury with high mortality and appropriate surgical treatment should be done as soon as possible. If there is any finding suggesting an intraoperative vascular injury, the patient should be kept under close monitoring in order not to delay diagnosis and treatment. It should not be forgotten that hemodynamic stability does not rule out major vascular injury.