Iatrogenic Vascular Injury Associated with Cervical Spine Surgery: A Systematic Literature Review

Area of Science:

• Neurosurgery
• Vascular Surgery
• Spine Surgery

Background:

• Iatrogenic vascular injury is an uncommon complication of anterior and/or posterior cervical spine surgery.
• These injuries can be life-threatening, but outcomes can be improved with proper understanding and management.

Purpose of the Study:

• To provide an updated review of vascular lesions following cervical spine surgery.
• To analyze the incidence, mechanisms, and outcomes of iatrogenic vascular injuries in cervical spine surgery.

Main Methods:

• A literature review of 72 articles was conducted, analyzing 194 cases of vascular lesions from 1962 to 2021.
• Cases were classified by surgical approach (anterior/posterior) and type of vascular injury.

Main Results:

• The vertebral artery was the most frequently injured vessel (86.60%).
• Laceration (41.24%) was the most common lesion, often caused by instrumentation/screw placement (31.44%) or drilling (20.61%).
• The mortality rate was 7.22%, with 18.04% experiencing other complications.

Conclusions:

• Vascular injury remains a significant risk in cervical spine surgery despite advances.
• Awareness of potential vascular complications and their mechanisms is essential for patient safety.