Aortic Injury during Transforaminal Lumbar Interbody Fusion

Aortic injury during transforaminal lumbar interbody fusion (TLIF) is a rare but severe complication. We experienced aortic injury during TLIF at L3-4 with a 59-year-old woman diagnosed with an adjacent segment disease at L3-4. Severe bleeding occurred during disc space expansion, and the blood pressure dropped to 60/40 mmHg. The patient's vital sign stabilized after compression with gauze and Gelfoam in addition to blood transfusion. The patient was treated with endovascular repair using a percutaneous technique after intertransverse fusion at L3-4 was completed. She recovered and is being followed-up in the outpatient department.