Vascular Complications in Spinal Surgery

Stambough, Jeffery L.; Clouse, Elisha K.

doi:10.1016/b978-1-4160-6726-9.00096-1

Cited by 3 publications

(6 citation statements)

References 322 publications

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“…Safe exposure of iliolumbar veins at L4/ L5 disc junction during anterior approach surgeries is needed [20,21,27.28] since iliolumbar vein communicates with valve less common iliac vein, injury to iliolumbar vein will lead to massive haemorrhage [18][19][20] though surgically significant relations are not much known, iliolumbar system was demonstrated in every cadaver, it drained the iliacus and the psoas muscles, and the fifth lumbar vertebra. A separate ascending lumbar vein running longitudinally to azygus system was seen [16,17,29] The mean distance of the iliolumbar veins from the inferior vena cava, overall, was 35± 9.9 mm.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11][12][13][14][15][16][17]during mobilization of great vessels to expose the L4/L5 junction ,surgeons have to careful not to injure the vein which can cause massive bleed. [18][19][20] this type of bleed can be controlled by dissection and ligation of vein during surgery. we tried to study detailed anatomy of iliolumbar veins.…”

Section: Anatomy Sectionmentioning

confidence: 99%

“…[18][19][20] this type of bleed can be controlled by dissection and ligation of vein during surgery. we tried to study detailed anatomy of iliolumbar veins.…”

Section: Introductionmentioning

confidence: 99%

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Morphometry of the Iliolumbar Artery and the Iliolumbar Veins and Their Correlations with the Lumbosacral Trunk and the Obturator Nerve

Teli

Kate²,

Kothandaraman³

2013

JCDR

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Objectives: To reveal the variations of the iliolumbar artery and the iliolumabar veins and their correlation with the surrounding important structures. Methods:We dissected the iliolumbar region bilaterally in 20 formalin-fixed adult cadavers. The diameter of the iliolumbar artery at its origin, its length up to the branching point, the distance between the iliolumbar artery and the inferior margin of the fifth lumbar vertebra and the distance between the iliolumbar artery and the bifurcation point of the common iliac artery, were measured. The pattern of drainage, the dimensions, the points of confluence with the common iliac vein and the obliquity of the iliolumbar vein were noted. The correlation between the iliolumbar artery and the veins to the obturator nerve and the lumbosacral trunk was recorded. Results:The iliolumbar artery originated from the posterior trunk of the internal iliac artery or from the internal iliac artery. The mean diameter of the iliolumbar artery, at its origin, was 3.5±0.5 mm. The mean distance between the origin of the iliolumbar artery and the bifurcation point to the iliac and the lumbar branches was 12.2±5.5 mm. The distance between the origin of the iliolumbar artery and the lower edge of the fifth lumbar vertebra was 43.2±11.6 mm. The distance between the origin of the iliolumbar artery and the bifurcation point of the common iliac artery was 38.7±10.6 mm.The mean distance of the iliolumbar veins from the inferior vena cava, overall, was 35± 9.9 mm. The mean width of the mouth of the iliolumbar vein was10.7 ± 5.1 mm and the mean angle of obliquity of the vein with respect to the long axis of the common iliac vein was 75.5 0 . The tributaries which drained into the main iliolumbar vein were variable.The iliolumbar artery passed anterior in 70% and it passed posterior to the obturator nerve in 30%. The veins were lying anterior to the obturator nerve in 45% and they were lying posterior in 55%. The multiple tributaries which drained into the iliolumbar vein relation of the tributaries were variable, few passed anterior and few passed posterior.The iliolumbar artery was seen anterior to the lumbosacral trunk in 30%, it was posterior in 54%, it was cleaved in 8% and the branches of the artery were passing on either side of the lumbosacral trunk to enclose it like a clasp in 8%. The veins were anterior to the lumbosacral trunk in 40% and they were posterior in 60%. Conclusion:The anatomical features of the iliolumbar artery, the iliolumbar veins and their correlation with the anatomical landmarks, which were presented here, would be helpful in decreasing the iatrogenic trauma to the neurovascular structures in the iliolumbar region. InTROduCTIOnThe iliolumbar artery classically arises from the posterior radix of the internal iliac artery and it extends in an oblique fashion superiorly and laterally, in front of the sacroiliac joint and the lumbosacral trunk. It crosses the obturator nerve and the external iliac artery and vein. Subsequently, it reaches the medial edge of th...

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Section: Discussionmentioning

confidence: 99%

Section: Anatomy Sectionmentioning

confidence: 99%

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Morphometry of the Iliolumbar Artery and the Iliolumbar Veins and Their Correlations with the Lumbosacral Trunk and the Obturator Nerve

Teli

Kate²,

Kothandaraman³

2013

JCDR

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“…Despite the fact that the reported incidence of vascular injuries associated with a lumbar discectomy is quite low (<0.05%), 9 but the mortality rate reported with such injuries is quite variable and ranges from 16% to as high as 100%. 6 Therefore, the most important thing in these cases is the rapid and accurate diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that the outcome of a vessel injury generally varies depending on the time taken to diagnose the injury, type of vascular injury, and time taken to take the patient for emergency intervention. [1][2][3][4][5][6][7] This emphasizes the importance of rapid diagnosis and timely as well as appropriate intervention in case of a vascular injury. Despite being a complication associated with such high mortality, reports on appropriate treatment for vascular injuries occurring during the spinal surgery are very few in number.…”

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confidence: 99%