Aortic Injury during Transforaminal Lumbar Interbody Fusion

Bae, Hee Jin; Cho, Tack Geun; Kim, Chang‐Hyun; Lee, Ho Kook; Moon, Jae Gon; Choi, Jong Il

doi:10.14245/kjs.2017.14.3.118

Cited by 8 publications

(2 citation statements)

References 12 publications

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“…It has been reported during surgical exposure, insertion of pedicle screws, vertebroplasty, lumbar discectomy, lumbar interbody fusions, and during 3-column osteotomies. 6,7 However, injury to the thoracic or abdominal aorta has not been reported during transpedicular bone grafting.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Abdominal Aortic Rupture During Transpedicular Bone Grafting for Thoracolumbar Burst Fractures Successfully Treated by Endovascular Stent Implantation

et al. 2023

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Purpose: Vascular injury resulting from transpedicular bone grafting in the treatment of thoracolumbar burst fractures has not been reported but can be lethal. The management of patients with iatrogenic aortic injury remains a difficult clinical problem. This study describes a case of iatrogenic abdominal aortic rupture at the level of L2 during transpedicular bone grafting for the first time. Case Report: A 55 year-old male patient suffered from a T12 vertebral body mild compression fracture and an L2 vertebral body burst fracture due to falling. This patient was treated with posterior open reduction and pedicle screw fixation combined with transpedicular bone grafting in the L2 vertebrae using a paravertebral approach. Unfortunately, during transpedicular bone grafting, the abdominal aorta was punctured by the tip of the graft funnel. The use of endovascular stent implantation successfully averted a clinical catastrophe. The patient had a good clinical outcome, and no complications associated with vascular trauma were apparent at a 1-year follow-up examination. Conclusion: For the repair of vascular injury caused by transpedicular bone grafting, endovascular techniques can provide a safe, minimally invasive, and effective treatment option. Clinical Impact Surgeons should carefully evaluate the specificity of the patient’s anatomical structures preoperatively and be more cautious during transpedicular bone grafting in the treatment of thoracolumbar burst fractures.

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Section: Discussionmentioning

confidence: 99%

Iatrogenic Abdominal Aortic Rupture During Transpedicular Bone Grafting for Thoracolumbar Burst Fractures Successfully Treated by Endovascular Stent Implantation

et al. 2023

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“…Thorough disc space preparation is especially important during MIS TLIF when the sole location of fusion is the interbody space (i.e., unless supplemental posterolateral or facet fusion has been performed). Great care should be taken during discectomy, however, because violation of the ALL can result in damage to surrounding structures (e.g., aorta) with life threatening consequences (52). Additionally, an intact ALL is necessary to contain bone graft and the interbody cage.…”

Section: Surgical Techniquementioning

confidence: 99%

Complication avoidance in minimally invasive spinal surgery

Derman¹,

Phillips²

2019

J Spine Surg

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Minimally invasive techniques in spinal surgery allow surgeons to perform operations with less of the approach-related morbidity inherent to traditional open procedures. Yet these muscle-sparing procedures come with a unique set of risks that stem from the novel approaches, limited exposure, and/or a restricted working corridor that they employ. The literature suggests that these operations can be performed without an increased rate of complication once the associated learning curve has been surmounted, suggesting that knowledge of and experience with the nuances of these procedures are essential for patient safety. The present article describes the complications specific to a variety of minimally invasive spinal surgeries and provides guidance on how to avoid them.

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