Iatrogenic vascular injury during to lumbar disc surgery

Erkut, Bilgehan; Ünlü, Yahya; Kayğın, Mehmet Ali; Çolak, Abdürrahim; Erdem, Alı Fuat

doi:10.1007/s00701-007-1132-2

Cited by 56 publications

(64 citation statements)

References 39 publications

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“…In patients undergoing lumbar disc surgery, major vascular injuries are rare but very serious, life-threatening complications (1)(2)(3)(4)(5). During the operation, in case of sudden hemodynamic instability, considering the possibility of a major vascular injury and dynamic intervention can be lifesaving (1)(2)(3)(4)(5) De Saussure has reported 106 cases of vascular injury due to lumbar disc surgery in 1958(4).…”

Section: Discussionmentioning

confidence: 99%

“…During the operation, in case of sudden hemodynamic instability, considering the possibility of a major vascular injury and dynamic intervention can be lifesaving (1)(2)(3)(4)(5) De Saussure has reported 106 cases of vascular injury due to lumbar disc surgery in 1958(4). In the literature, the mechanism of injury is generally described by progression of the forceps used in disc surgery across the anterior longitudinal ligament into the retroperitoneal space (1-5).…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, the mechanism of injury is generally described by progression of the forceps used in disc surgery across the anterior longitudinal ligament into the retroperitoneal space (1-5). Although exact rate of vascular injuries is not known, it is usually reported in the range of 0.01 to 0.2% (1)(2)(3)(4)(5). Overall mortality rate ranges from 15-65% (1-3).…”

Section: Discussionmentioning

confidence: 99%

“…The most common injury is related to L4-L5 and L5-S1 disc surgery (4,5,8). At this level the common iliac vessels emerge and injury to these vessels is more common (4).…”

Section: Discussionmentioning

confidence: 99%

“…Major vascular injury is one of them and it may be fatal if not noticed in time (1). This type of injury is more common especially during lumbar region intervertebral disc surgery, due to proximity of the anterior longitudinal ligament and major vascular structures located anteriorly (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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Abdominal aortic injury due to lumbar disc surgery: A case report

Yıldız

Öztaş

Şahin

et al. 2014

UCD

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Complications arising from lumbar intervertebral disc surgery are rare but fatal. Major vascular injury is one complication that may end in death unless it is diagnosed and treated immediately. Herein we report an abdominal aortic injury due to L3-L4 intervertebral disc surgery that was treated successfully and discuss it in light of current literature. Diagnosis and treatment of an abdominal aortic injury in a 31-year-old male patient operated on for L3-L4 intervertebral disc degeneration is discussed. Interestingly, in spite of abdominal aortic injury this particular patient was hemodynamically stable. The diagnosis was made 12 hours after disc surgery and laparotomy was performed immediately. As the injury in the aorta was large and had irregular margins, it could not be repaired with primary repair but an end-to-end anastomosis with partial resection was performed. In lumbar intervertebral disc hernia surgery, peroperative hemodynamic instability should raise suspicion of major vascular injury with high mortality and appropriate surgical treatment should be done as soon as possible. If there is any finding suggesting an intraoperative vascular injury, the patient should be kept under close monitoring in order not to delay diagnosis and treatment. It should not be forgotten that hemodynamic stability does not rule out major vascular injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The most common injury is related to L4-L5 and L5-S1 disc surgery (4,5,8). At this level the common iliac vessels emerge and injury to these vessels is more common (4).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Abdominal aortic injury due to lumbar disc surgery: A case report

Yıldız

Öztaş

Şahin

et al. 2014

UCD

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Management of Iatrogenic Abdominal Vascular Injuries

Ramos¹,

Rajani²

2021

Vascular Complications of Surgery and Intervention

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Morphometric analysis of the lumbar vertebrae and intervertebral discs in relation to abdominal aorta: CT-based study

Kot¹,

Polak

Klepinowski

et al. 2021

Surg Radiol Anat

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Purpose Although lumbar discectomy is the most common procedure in spine surgery, reports about anatomical relations between discs and prevertebral vessels are limited. Aim of this research was to investigate morphometric of the lumbar region and the relations between intervertebral discs (IVDs) and abdominal aorta. Methods 557 abdominal computed tomography scans were assessed. For each spinal column level from Th12/L1 down to L4/L5, we investigated: intervertebral disc’s and vertebra’s height, width, length, and distance from aorta or common iliac artery (CIA). Those arteries were also measured in two dimensions and classified based on location. Results 54.58% of patients were male. There was a significant difference in arterial-disc distances (ADDs) between genders at the levels: L1/L2 (1.32 ± 1.97 vs. 0.96 ± 1.78 mm; p = 0.0194), L2/L3 (1.97 ± 2.16 vs. 1.15 ± 2.01 mm; p < 0.0001), L3/L4 (2.54 ± 2.78 vs. 1.71 ± 2.61 mm; p = 0.0012), also for both CIAs (left CIA 3.64 ± 3.63 vs. 2.6 ± 3.06 mm; p = 0.0004 and right CIA: 7.96 ± 5.06 vs. 5.8 ± 4.57 mm; p < 0.001)—those ADDs were higher in men at all levels. The length and width of IVD increased alongside with disc level with the maximum at L4/L5. Conclusion Bifurcations of the aorta in most cases occurred at the L4 level. Collected data suggest that at the highest lumbar levels, there is a greater possibility to cause injury of the aorta due to its close anatomical relationship with discs. Females have limited, in comparison to males, ADD at L1/L2, L2/L3, and L3/L4 levels what should be taken into consideration during preoperative planning of surgical intervention.

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Iatrogenic vascular injury during to lumbar disc surgery

Cited by 56 publications

References 39 publications

Abdominal aortic injury due to lumbar disc surgery: A case report

Abdominal aortic injury due to lumbar disc surgery: A case report

Management of Iatrogenic Abdominal Vascular Injuries

Morphometric analysis of the lumbar vertebrae and intervertebral discs in relation to abdominal aorta: CT-based study

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