Vertebral artery injuries in cervical spine surgery

Lunardini, David; Eskander, Mark S.; Even, Jesse L.; Dunlap, James T.; Chen, Antonia F.; Lee, Joon Y.; Ward, Timothy W.; Kang, James D.; Donaldson, William F.

doi:10.1016/j.spinee.2013.09.016

Cited by 98 publications

(83 citation statements)

References 11 publications

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“…In this study, no cases of VA injury were documented, which is not surprising, given the low incidence of such injuries reported in the literature. In addition, a recent report revealed that the fatality rate of VA injury was 4.5% (18). Presumably, with increasing awareness of this complication, VA injury has become less frequent and more manageable, resulting in increased safety of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Risks of In-Hospital Death and Complications After Fusion Surgery in Patients with Atlantoaxial Subluxation: Analysis of 1090 Patients Using the Japanese Diagnosis Procedure Combination Database

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Risks of In-Hospital Death and Complications After Fusion Surgery in Patients with Atlantoaxial Subluxation: Analysis of 1090 Patients Using the Japanese Diagnosis Procedure Combination Database

et al. 2015

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“…As far as we are aware this is the first reported case of delayed vertebral artery dissection following a posterior foraminotomy and rhizolysis [1–3]. The precise pathophysiology of this complication is difficult to determine given that there was no evidence of injury to the vertebral artery at the time of surgery and there had been no abnormal movements of the neck.…”

Section: Discussionmentioning

confidence: 99%

“…Vertebral artery injury is a rare but potentially catastrophic complication of cervical spinal surgery with a reported incidence of 0.07% [1]. Those injuries that have been reported have most commonly involved an anterior approach or following lateral mass screw placement to the cervical spine.…”

Section: Introductionmentioning

confidence: 99%

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Vertebral artery dissection following a posterior cervical foraminotomy

Sheth

Honeybul

2017

Journal of Surgical Case Reports

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Vertebral artery dissection following a posterior cervical foraminotomy with rhizolysis of the subaxial spine has not been described before. A 46-year-old lady underwent the procedure for a left C6 radiculopathy with a focal disc herniation with no intraoperative complications. Seven hours post-operatively, she developed a right homonymous hemianopia, thalamic dysphasia, gait and memory impairment. Imaging demonstrated an occlusion to the left vertebral artery from C7/T1 to C4 with a dissection flap noted at the inferior margin. This was further complicated with thrombosis of the dissected artery and subsequent emboli causing acute posterior circulation infarctions. Given that the dissection occurred at the level of the surgery, an indirect surgical cause is likely. We hypothesize that the vibration transmitted via bone from the high-speed drill led to arterial injury and dissection.

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“…Esto quiere decir, siguiendo los lineamientos de la FDA, que la discusión dentro de las alternativas de tratamiento estaría entre no hacer nada o la cirugía. La opción quirúrgica en este tipo de patología no sólo es limitada en cuanto a buenos resultados se refiere, sino que además existe mayor probabilidad de causar los daños descritos en la alerta en cuestión (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Es difícil entender que la indicación y utilización de estos medicamentos por esta vía "que es una práctica común y por décadas" no haya sido discutida por esta Agencia con anterioridad.…”

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