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Published on: December 10, 2020
Intraoperative Vertebral Artery Injury: Evaluation, Management, and Prevention
Nathan Redlich1, Daniel Gelvez1, Katherine Dong1
1LSUHSC Orthopaedic Surgery Resident, 2021 Perdido Street, 7th Floor, New Orleans, LA 70112, USA.
Abstract:
Vertebral artery injury (VAI) is a serious and potentially life-threatening injury that is encountered with trauma to the cervical spine and less frequently during surgery. VAI can occur during either anterior or posterior cervical approaches or instrumentation and often involves anomalous courses of the artery. Although the incidence is rare, serious consequences including fistula formation, thrombosis, pseudoaneurysm development, cerebral ischemia, hemorrhage, and death may occur. Management of VAI can be divided into prevention, including review of preoperative imaging with knowledge of the anatomic course, utilization of surgical landmarks intraoperatively, and prompt recognition and management when injury is encountered.
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