Vascular injury in thoracolumbar spinal surgeries and role of angiography in early diagnosis and management

Hak Sun Kim, Hyon Su Chong, Ankur Nanda, Jin Oh Park, Seong Hwan Moon, Hwan Mo Lee, Ho Joong Kim, Chun Kun Park, Ye Soo Park, Suk Ha Lee, Eun Su Moon

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Objective: To stress on the importance of early diagnosis with the help of angiography and proper treatment of vascular injuries occurring during thoracolumbar surgeries and to report our results. Summary of background data: Vascular injury is a rare but dangerous complication that can develop during thoracolumbar surgeries and if not treated properly then it can lead to severe complications including the death of the patient. Methods: The patients included in this study were the ones who were suspected to have a possible vascular injury after a thoracolumbar surgery. Contrast enhanced computed tomography was performed for patients having clinical signs suggesting vascular injury. Among these patients, who were suspected to have active bleeding and major vessel injury on computed tomography were further subjected to angiography. Results: Of the 10 cases included in the study, vascular injury was identified to be arterial in origin in 8 cases and venous in 3 cases. Among the 8 cases of identified arterial injury, angiography was performed in 4 cases, of which 3 were found to have active bleeding and were subjected to immediate intervention. Of the 4 cases in which angiography was not performed, 3 of them expired at variable postoperative periods. Complications developed in total 5 cases including 3 cases of mortality, 1 case of infection, and 1 case of cauda equina syndrome. Conclusions: The vascular injuries during thoracolumbar spinal surgeries need immediate and aggressive treatment. In arterial injuries, we can prevent serious consequences by subjecting the patient to an angiography as early as possible followed by a therapeutic embolization. In contrast, for venous injuries if hemostasis has been confirmed, then an immediate intervention may not be always required.

Original languageEnglish
Pages (from-to)418-424
Number of pages7
JournalJournal of Spinal Disorders and Techniques
Volume23
Issue number6
DOIs
Publication statusPublished - 2010 Aug

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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