Segmental T12 Vertebral Artery Injury Treated by Endovascular Coil Placement after Kyphoplasty for Symptomatic Spinal Angioma. Case Report of a Minimal Invasive Solution for a Complication of a Minimally Invasive Spine Procedure

Abstract

Background: Vertebral angioma is a tumor defined as an abnormality of vascular tissue development. It usually has an asymptomatic behavior, being present in 10%-12% of autopsies and imaging studies.

Case description: A 70-year-old man consulted because of a long history of low back pain. Imaging studies were compatible with vertebral angioma at T12; we decided to perform a minimally invasive surgical procedure, such as kyphoplasty. During surgery, there was a sharp decrease in pulmonary saturation, and the patient underwent a computed tomography scan evaluation confirming a left hemothorax due to segmental branch vascular injury at T12. Given the patient's poor medical condition and the complexity of an emergent open procedure in the thoracic spine, we decided to undertake a minimally invasive endovascular coil placement to repair the vascular injury. Due to a favorable outcome, we discharged the patient after 72 hours of surveillance.

Conclusions: Even in the case of a complication to occur, we should always consider a minimally invasive solution to solve the problem because patients undergoing these procedures correspond to elderly patients with poor medical conditions or comorbidities.

Keywords: Case report; Kyphoplasty; Minimally invasive spine surgery; Vascular injury; Vertebral angioma.