Median Sacral Artery Rupture as a Complication of Posterior-Only Approach of L4 Total En Bloc Spondilectomy: A Case
Beatriz Garcia-Maya1, Javier Pizones, Jose Miguel Sanchez-Marquez
1Spine Unit, Department of Orthopedic Surgery, Hospital Universitario La Paz, Madrid, Spain.
Case:
A 6-year-old patient with Ewing sarcoma at L4 who was treated with total en bloc spondilectomy (TES) through a posterior-only approach. During the dissection of the anterior L4 body, there was uncontrollable bleeding from an unknown origin, which needed packing, massive transfusion, and urgent laparotomy. A median sacral artery (MSA) rupture was identified as the cause of this massive bleeding. Eventually, the patient was successfully stabilized.
Conclusions:
To our knowledge, this is the first reported intraoperative bleeding of the MSA related to a lumbar TES through posterior-only approach. This life-threatening complication should be considered when planning for this type of surgery.
More Related Videos
07:44Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis
Published on: October 17, 2025
03:24Author Spotlight: Development and Application of a Novel Suture Technique for Annular Fibrosus Repair in Percutaneous Transforaminal Endoscopic Discectomy
Published on: January 26, 2024
