Injury of a medial sacral vessel during lumbar laminectomy

Vascular injury sustained during neurosurgical procedures is surprisingly rare, especially considering the anatomic proximity of major blood vessels to the vertebral column. Mortality rates are high if the injury is not recognized and definitive management is delayed. Case reports include massive hemorrhage, arteriovenous fistulas, and development of false aneurysms. Diagnostic CT scan and arteriography are useful if the patient's condition permits; however, rapid intervention is crucial to the patient's survival. After reviewing the current surgical literature, we present a case of medial sacral artery injury occurring during laminectomy.