Turkish Neurosurgery
2013 , Vol 23 , Num 3
Iatrogenic Major Vascular Injury During Lumbar Discectomy: Report of Three Cases
Istanbul University, Istanbul Faculty of Medicine, Department of General Surgery, Fatih, Istanbul, Turkey
DOI :
10.5137/1019-5149.JTN.4930-11.1
Iatrogenic vascular injury rarely occurs during lumbar disc surgery and can be fatal if it is not recognized instantly. In this paper we aim
to introduce three iatrogenic vascular injuries that occurred during the lumbar disc surgery. The first case was consulted because of the
sudden hypotension attack during lumbar disc surgery. The left common iliac artery and bilateral common iliac vein injuries were detected
in emergency laparotomy, and repaired primarily. The second case was consulted to our clinic because of the hypotension attack at the first
postoperative day. Left common iliac artery and vein injuries were diagnosed by CT angiography. Left common iliac vein was ligated and left
common iliac arterial injury was repaired primarily by laparotomy. The third case was referred to our clinic for left lower extremity ischemia.
Left common iliac artery injury was diagnosed by simple physical examination. Reconstruction by PTFE graft interposition was performed. The
first patient died due to disseminated intravascular coagulation at the early postoperative period. Pulmonary embolus developed in the iliac
vein ligated patient but was well treated by anticoagulant therapy. The last patient was discharged without any problem. Two of the patients
are well on long-term follow-up.
Keywords :
Discectomy, Vascular injury, Reconstruction, Ven ligation