Vascular complications related to lumbar disc surgery

被引:69
作者
Bingol, H
Cingoz, F
Yilmaz, AT
Yasar, M
Tatar, H
机构
[1] Gulhane Mil Med Acad, Dept Cardiovasc Surg & Neurosurg, Ankara, Turkey
[2] Gulhane Mil Med Acad, Emergency Dept Surg, Ankara, Turkey
关键词
vascular surgery; complication; lumbar disc surgery; retroperitoneal approach; hemorrhage; graft;
D O I
10.3171/spi.2004.100.3.0249
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Object. Vascular complications related to lumbar disc operations are rare but extremely fatal conditions. The authors analyzed data retrospectively obtained in 13 patients with vascular complications that occurred during lumbar disc operations performed between January 1990 and January 2002. Methods. One patient underwent,in L5-S1 procedure and the remaining underwent L4-5 surgery. Missed injuries, which were found during the late postoperative period, included pseudoaneurysm in four cases and an arteriovenous fistula in one. In all cases except one in which complication occurred early in the postoperative period, the retroperitoneal area was reached via a transperitoneal approach. In eight patients with complications occurring early in the postoperative period, Dacron graft was placed in four with arterial injuries and saphenous vein graft in one. In three cases of arterial injury and five of venous injury, the lesion was repaired using the primer suture technique. The most commonly affected vessels were left common iliac arteries (76.9%) and left common iliac vein (30.8%). In eight early cases, shock or preshock due to hemorrhage developed during the early phase. During the late postoperative period, graft-related infection occurred in two cases in which Dacron graft was placed, and axillofemoral extraanatomical bypass surgery was later performed. There was no surgery-related death. During a mean follow-up period of 5.6 years, none of the patients suffered any problems related to vascular injury. Conclusions. Despite its low incidence. iatrogenic vascular injury related to lumbar disc surgery is a possible complication. During lumbar disc operations early diagnosis of vascular injuries and urgent transperitoneal surgery can save patients' lives.
引用
收藏
页码:249 / 253
页数:5
相关论文
共 18 条
  • [1] ANTERIOR PERFORATIONS IN LUMBAR DISCECTOMIES - A REPORT OF 4 CASES OF VASCULAR COMPLICATIONS AND A CT STUDY OF THE PREVERTEBRAL LUMBAR ANATOMY
    ANDA, S
    AAKHUS, S
    SKAANES, KO
    SANDE, E
    SCHRADER, H
    [J]. SPINE, 1991, 16 (01) : 54 - 60
  • [2] BREWSTER DC, 1979, ARCH SURG-CHICAGO, V114, P1026
  • [3] DUQUE AC, 1991, J CARDIOVASC SURG, V32, P783
  • [4] Major vascular injury during lumbar laminectomy
    Ezra, E
    Richenberg, JL
    Smellie, WAB
    [J]. JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, 1996, 89 (02) : P108 - P109
  • [5] Vascular complications of lumbar disc surgery
    Fruhwirth, J
    Koch, G
    Amann, W
    Hauser, H
    Flaschka, G
    [J]. ACTA NEUROCHIRURGICA, 1996, 138 (08) : 912 - 916
  • [6] Vascular and visceral injuries associated with lumbar disc surgery: Medicolegal implications
    Goodkin, R
    Laska, LL
    [J]. SURGICAL NEUROLOGY, 1998, 49 (04): : 358 - 370
  • [7] MAJOR VASCULAR COMPLICATIONS OF INTERVERTEBRAL DISC SURGERY
    HARBISON, SP
    [J]. ANNALS OF SURGERY, 1954, 140 (03) : 342 - 348
  • [8] HILDRETH DH, 1977, SURGERY, V81, P512
  • [9] CHALLENGE OF ARTERIOVENOUS-FISTULA FORMATION FOLLOWING DISK SURGERY - COLLECTIVE REVIEW
    JARSTFER, BS
    RICH, NM
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1976, 16 (09) : 726 - 733
  • [10] ARTERIOVENOUS-FISTULA FOLLOWING LUMBAR-DISK SURGERY
    MAY, ARL
    BREWSTER, DC
    DARLING, RC
    BROWSE, NL
    [J]. BRITISH JOURNAL OF SURGERY, 1981, 68 (01) : 41 - 43