Iatrogenic Common Iliac Vessel Injury During Routine Degenerative Lumbar Spine Surgery: Report of 2 Cases and Review of Literature

World Neurosurg. 2020 May:137:111-118. doi: 10.1016/j.wneu.2020.01.168. Epub 2020 Feb 14.

Abstract

Background: Injury of the iliac vessels is a rare complication of lumbar spine surgery with potentially life-threatening consequences. We present 2 cases of iliac vessel injury that were treated with minimally invasive techniques.

Case description: The first case was a laceration of the common iliac artery during a simple L4-L5 discectomy in which the injured artery was secured by stent implantation. The second case was an example of injury to the left iliac common vessel leading to acute lower limb ischemia and arteriovenous fistula formation after lumbar spinal canal stenosis surgery. The patient was treated in 2 steps. First, a temporary femorofemoral bypass was implanted to revascularize the right lower limb. The second step involved stent implantation in the right common iliac artery to close the arteriovenous fistula. Both patients were treated without extensive laparotomy and had good clinical outcomes.

Conclusions: This case series emphasizes the benefit of quick minimally invasive vascular repair available in multidisciplinary centers.

Keywords: Arteriovenous fistula; Complication; Endovascular treatment; Femorofemoral bypass; Lumbar spine surgery; Pseudoaneurysm; Vascular injury.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Arteriovenous Fistula / diagnosis
  • Arteriovenous Fistula / surgery*
  • Blood Vessel Prosthesis Implantation* / methods
  • Endovascular Procedures / methods
  • Female
  • Humans
  • Iliac Artery / diagnostic imaging
  • Iliac Artery / surgery*
  • Intervertebral Disc Displacement / surgery
  • Lumbar Vertebrae / blood supply
  • Lumbar Vertebrae / surgery*
  • Neurosurgical Procedures / adverse effects