Carotid Artery Injury in Anterior Cervical Spine Surgery: Multicenter Cohort Study and Literature Review

Härtl, Roger; Alimi, Marjan; Boukebir, Mohamed Abdelatif; Berlin, Connor; Navarro-Ramírez, Rodrigo; Arnold, Paul M.; Fehlings, Michael G.; Mroz, Thomas E.; Riew, K. Daniel

doi:10.1177/2192568216688192

Cited by 19 publications

(9 citation statements)

References 9 publications

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“…Major vessels laceration during ACDF procedures is rare. However, one should never forget the proximity of the carotid and vertebral arteries to the surgical site [5, 18]. In case of such an event, hemostasis can be achieved by either packing the vessel or, in extensive lesions, surgical repair of the defect [5].…”

Section: Discussionmentioning

confidence: 99%

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Anterior Cervical Discectomy and Fusion combined with thyroid gland surgery, a tailored case and literature review

Themistoklis

Korfias

Papasilekas

et al. 2019

BMC Musculoskelet Disord

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BackgroundNowadays, Anterior Cervical Discectomy and Fusion (ACDF) is considered a routine procedure. However, unexpected difficulties do occasionally arise, especially when anterior neck pathologies or anatomical variations are encountered. In such cases, proactive thinking will allow surgeons to tailor appropriately their approach and eliminate surgical risks.Case presentationWe present the case of a 50-year-old male patient suffering from left upper limb radiculopathy that underwent a C7-T1 ACDF combined with a hemithyroidectomy. Excision of the right thyroid lobe was offered to the patient because of a goiter found during the preoperative work-up. Furthermore, the hemithyroidectomy provided a wide surgical field so the ACDF performed without excreting excessive traction to the adjacent neck structures.ConclusionsThe patient had an uncomplicated post-operative. To our knowledge this is the first report of a planned hemithyroidectomy being carried out as the first step towards an ACDF procedure.

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Section: Discussionmentioning

confidence: 99%

“…Other vascular complications include arterial dissections as well as embolic strokes due to carotid artery compression. To avoid the latter, intermittent temporary release of the traction is recommended in prolonged cases [18].…”

Section: Discussionmentioning

confidence: 99%

Anterior Cervical Discectomy and Fusion combined with thyroid gland surgery, a tailored case and literature review

Themistoklis

Korfias

Papasilekas

et al. 2019

BMC Musculoskelet Disord

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show abstract

“…Iatrogenic carotid artery injuries during anterior cervical spine surgeries are rare and not extensively reported in the literature. There is neither evidence that the prolonged carotid artery sheath traction during anterior cervical approaches results in the reduction of carotid blood flow and cerebrovascular accidents [64][65][66]. Vertebral artery damages due to anterior cervical spine procedures are infrequent, with an incidence of 0.1-0.5% [55,67,68].…”

Section: Management Tipsmentioning

confidence: 99%

Rating the incidence of iatrogenic vascular injuries in thoracic and lumbar spine surgery as regards the approach: A PRISMA-based literature review

et al. 2021

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Purpose To assess the rate, timing of diagnosis, and repairing strategies of vascular injuries in thoracic and lumbar spine surgery as their relationship to the approach. Methods PubMed, Medline, and Embase databases were utilized for a comprehensive literature search based on keywords and mesh terms to find articles reporting iatrogenic vascular injury during thoracic and lumbar spine surgery. English articles published in the last ten years were selected. The search was refined based on best match and relevance. Results Fifty-six articles were eligible, for a cumulative volume of 261 lesions. Vascular injuries occurred in 82% of instrumented procedures and in 59% during anterior approaches. The common iliac vein (CIV) was the most involved vessel, injured in 49% of anterior lumbar approaches. Common iliac artery, CIV, and aorta were affected in 40%, 28%, and 28% of posterior approaches, respectively. Segmental arteries were injured in 68% of lateral approaches. Direct vessel laceration occurred in 81% of cases and recognized intraoperatively in 39% of cases. Conclusions Incidence of iatrogenic vascular injuries during thoracic and lumbar spine surgery is low but associated with an overall mortality rate up to 65%, of which less than 1% for anterior approaches and more than 50% for posterior ones. Anterior approaches for instrumented procedures are at risk of direct avulsion of CIV. Posterior instrumented fusions are at risk for injuries of iliac vessels and aorta. Lateral routes are frequently associated with lesions of segmental vessels. Suture repair and endovascular techniques are useful in the management of these severe complications.

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“… 22) In addition, vascular injury due to cervical spine surgeries is rare but fatal, and involve various blood vessels, including vertebral artery (VA), carotid artery, thyroid arteries, or internal jugular vein. 24 45 55 57)…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Management of Iatrogenic Vertebral Artery Injury Associated With Cervical Spine Surgery

2022

Korean J Neurotrauma

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Iatrogenic vertebral artery injury (VAI) caused by surgical interventions involving the cervical spine is an uncommon but catastrophic complication associated with high morbidity or mortality due to ischemic stroke, intra- or extra-dural hemorrhage, and the formation of pseudoaneurysm or arteriovenous fistulae. In cervical spine surgeries, VAI may occur during the peri- or postoperative period. This may be induced by an anterior or posterior surgical approach. Despite advanced imaging techniques and increased anatomical knowledge, VAI during cervical spinal surgery remains a challenge. Techniques for managing VAI include hemostatic tamponade, ligation, microvascular repair or anastomosis, and endovascular management. We need to consider the risk of iatrogenic VAI as a complication in patients undergoing cervical spine surgeries and a better understanding of its mechanism and proper management.

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Carotid Artery Injury in Anterior Cervical Spine Surgery: Multicenter Cohort Study and Literature Review

Cited by 19 publications

References 9 publications

Anterior Cervical Discectomy and Fusion combined with thyroid gland surgery, a tailored case and literature review

Anterior Cervical Discectomy and Fusion combined with thyroid gland surgery, a tailored case and literature review

Rating the incidence of iatrogenic vascular injuries in thoracic and lumbar spine surgery as regards the approach: A PRISMA-based literature review

Epidemiology and Management of Iatrogenic Vertebral Artery Injury Associated With Cervical Spine Surgery

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