Iatrogenic arterial injuries of spine and orthopedic operations

Hans, Sachinder Singh; Shepard, Alexander D.; Reddy, Pritham; Rama, Kumara; Romano, William

doi:10.1016/j.jvs.2010.08.084

Cited by 31 publications

(19 citation statements)

References 13 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6,7 Consistent with contemporary literature this study reports similar findings. 1,5,7 The one arterial injury we report was unrelated to the exposure; however, it is important to emphasize that the instrumentation has significant potential complications and it is strongly recommended that all surgeons remain close during the procedure and that a team approach is employed when retractors need re-adjustment to accommodate bulky instruments ( Figure 2). Venous injury is considered more likely to occur with secondary exposure due to adhesions.…”

Section: Discussionsupporting

confidence: 92%

“…Chiriano et al 6 reported a 3% rate of lifethreatening vascular injury and Hans et al 7 reported five of 560 (1%) patients with ARES developed significant arterial complications. 6,7 Consistent with contemporary literature this study reports similar findings. 1,5,7 The one arterial injury we report was unrelated to the exposure; however, it is important to emphasize that the instrumentation has significant potential complications and it is strongly recommended that all surgeons remain close during the procedure and that a team approach is employed when retractors need re-adjustment to accommodate bulky instruments ( Figure 2).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A team approach to anterior lumbar spine surgery in the military

et al. 2013

View full text Add to dashboard Cite

We report a five year military experience with anterior retroperitoneal spine exposure combining vascular and neurosurgical spine teams. From August 2005 through April 2010 (56 months), hospital records from a single institution were retrospectively reviewed. Complications, estimated blood loss, transfusions, operative time and length of stay were documented. Eighty-four patients with lumbar spondylosis underwent primary (63, 75%) or secondary exposure (21, 25%) of a single- (66, 79%) or multilevel disc space (18, 21%). Median operative time and estimated blood loss were 127 minutes (range, 30-331 minutes) and 350 mL (range, 0-2940 mL). The overall complication rate was 23.8%. Postoperative complications included six blood transfusions (7%), three patients with retrograde ejaculation (3.57%) or surgical site infection; two with a prolonged ileus (2.38%) or ventral hernia and one each with a bowel obstruction (1, 1.19%), deep venous thrombosis or lymphocele. All-cause mortality was 1%. In conclusion, a team approach can minimize complications while offering the technical benefits and durability of an anterior approach to the lumbar spine.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

A team approach to anterior lumbar spine surgery in the military

et al. 2013

View full text Add to dashboard Cite

show abstract

“…The source for the neurological impairment can be central (motor neuron disease, parasagittal cortical or subcortical cerebral lesions) or peripheral (lumbar radiculopathy, mononeuropathies of the deep peroneal, common peroneal, or sciatic nerves) [1-3]. In addition, there have been several case reports of foot drop due to an unusual etiology such as Baker's cyst [4], Hodgkin's lymphoma [5], Perineurioma [6], Paget's disease [7] and iatrogenic foot drop after spinal anesthesia [8] or lumbar surgery [9,10]. …”

Section: Introductionmentioning

confidence: 99%

Foot Drop Caused by Lumbar Degenerative Disease: Clinical Features, Prognostic Factors of Surgical Outcome and Clinical Stage

et al. 2013

View full text Add to dashboard Cite

ObjectiveThe purpose of this study was to analyze the clinical features and prognostic factors of surgical outcome of foot drop caused by lumbar degenerative disease and put forward the clinical stage.MethodsWe retrospectively reviewed 135 patients with foot drop due to lumbar degenerative disease. The clinical features and mechanism were analyzed. Age, sex, duration of palsy, preoperative muscle strength of tibialis anterior (TA), sensation defect of affected lower limb, affected foot, diagnosis and compressed nerve roots were recorded and compared with surgical outcome.ResultsFoot drop was observed in 8.1% of all inpatients of lumbar degenerative disease. L5 nerve root compression was observed in 126 of all 135 patients (93.3%). Single, double and triple roots compression was observed respectively in 43, 83, and 9 patients (31.9%, 61.5%, and 6.6%). But there was no significant relationship between preoperative muscle strength of TA and the number of compressed roots. The muscle strength of TA was improved in 113 (83.7%) patients after surgery, but it reached to >=4 in only 21 (15.6%) patients. Improvement of the muscle strength of TA was almost stable at the 6-month follow-up. At the last follow-up, the muscle strength of TA was 1, 2, 3, 4, 5 respectively in 28, 24, 62, 13, 8 patients. Multivariate logistic regression showed duration of palsy (p=0.0360, OR=2.543), preoperative muscle strength of TA (p=0.0064, OR=5.528) and age (p=0.0309, OR=3.208) were factors that influenced recovery following an operation.ConclusionsL5 nerve root was most frequently affected. The muscle strength of TA improved in most patients after surgery, but few patients can get a good recovery from foot drop. Patients of shorter duration of palsy, better preoperative muscle strength of TA and younger age showed a better surgical outcome.

show abstract

“…Iatrogenic vascular injuries, due to the particular nature of such pathology, are associated with high morbidity and mortality in the postoperative period. 1,2 This dangerous and sometimes life-threatening complication is being increasingly reported in the literature. It results mainly from the large number of diagnostic and therapeutic interventions requiring vascular access, as well as complex and extensive surgical repair procedures.…”

Section: Introductionmentioning

confidence: 99%

Endovascular treatment of iatrogenic arteriovenous fistula of the iliac vessel

et al. 2018

View full text Add to dashboard Cite

Iatrogenic vessel injury, being a complication of neurosurgical and orthopedic surgeries, may be overlooked and remain undetected both in intraand postoperative period. Modern imaging techniques allow for an adequate diagnosis of the injury and planning the treatment of arteriovenous fistula. The endovascular procedures are the method of choice in patients with arteriovenous fistulas of iliac vessels, alternative to open surgery.

show abstract

Iatrogenic arterial injuries of spine and orthopedic operations

Cited by 31 publications

References 13 publications

A team approach to anterior lumbar spine surgery in the military

A team approach to anterior lumbar spine surgery in the military

Foot Drop Caused by Lumbar Degenerative Disease: Clinical Features, Prognostic Factors of Surgical Outcome and Clinical Stage

Endovascular treatment of iatrogenic arteriovenous fistula of the iliac vessel

Contact Info

Product

Resources

About