Spinal cord ischemia after ligation of both internal iliac arteries during radical cystoprostatectomy

In radical cystectomy where control of the blood supply is desirable, ligation of both internal iliac arteries is to be avoided. The lumbar part of the spinal cord and cauda equina receive arterial radicular branches via the posterior trunks of the internal iliac arteries. Thus, bilateral ligation of these vessels might cause ischemia of the lower part of the spinal cord.