Vascular Complications Related to Posterior Lumbar Disc Surgery
10.5758/vsi.2017.33.4.160
- Author:
Hong Sung JUNG
1
;
Dae Jung KIM
;
Hyo Shin KIM
;
Ho Kyun LEE
;
Soo Jin Na CHOI
;
Sang Young CHUNG
Author Information
1. Department of Surgery, Chonnam National University Hospital, Gwangju, Korea. sycpvts@chonnam.ac.kr
- Publication Type:Original Article
- Keywords:
Vascular system injuries;
Discectomy;
Vascular surgical procedures;
Endovascular procedures
- MeSH:
Aneurysm, False;
Arteriovenous Fistula;
Blood Vessel Prosthesis;
Diagnosis;
Diskectomy;
Endovascular Procedures;
Fatal Outcome;
Humans;
Iliac Artery;
Jeollanam-do;
Lacerations;
Mortality;
Retrospective Studies;
Supine Position;
Vascular Surgical Procedures;
Vascular System Injuries;
Vital Signs
- From:Vascular Specialist International
2017;33(4):160-165
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate patients who underwent surgical or endovascular treatment after vascular injury related to posterior lumbar disc surgery. MATERIALS AND METHODS: We retrospectively reviewed seven cases of vascular injuries (four lacerations, one arteriovenous fistula [AVF], and two pseudoaneurysms) related to lumbar disc surgery by a posterior approach from January 1997 to December 2016 at Chonnam National University Hospital. Information of patient characteristics, diagnosis, treatment strategies, and outcomes were analyzed. RESULTS: Five out of seven cases were inhospital cases. In three laceration cases, each patient instantly became hypotensive and a life-threatening arterial injury was suspected. Therefore, the patient was immediately turned to the supine position and surgical repair was performed. The patients with pseudoaneurysm and AVF were treated by endovascular intervention. Remaining two were referred cases under the impression of vascular injuries. One laceration case of them was in preshock condition, and the left common iliac artery was surgically repaired. The other referred patient showed pseudoaneurysm which was treated with stent graft insertion. There was no surgery or endovascular intervention related death and none of the patients suffered any sequela related to vascular injury. CONCLUSION: Vascular injury associated with posterior lumbar disc surgery is not common, but can be fatal. Early recognition, diagnosis, and prompt treatment are essential to prevent fatal outcomes. Recently, endovascular intervention is increasingly and preferably used because of its low morbidity and mortality. However surgery is still the best option for the patients with unstable vital sign and endovascular approach can be applied to stable patients.
