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Endovascular Management of Iatrogenic Vertebral Artery Transection During Anterior Cervical Spine Surgery: A Case Report

Neurospine 2021년 18권 1호 p.245 ~ 249
Padhi Rasmiranjan, Kandasamy Sathish, Kumaran Balasenthil, Bheemarao Pranesh Madakasira, Kumaran Senthil,
소속 상세정보
 ( Padhi Rasmiranjan ) - G. Kuppuswamy Naidu Memorial Hospital Department of Imaging Services and Interventional Radiology
 ( Kandasamy Sathish ) - G. Kuppuswamy Naidu Memorial Hospital Department of Imaging Services and Interventional Radiology
 ( Kumaran Balasenthil ) - G. Kuppuswamy Naidu Memorial Hospital Department of Neurosurgery
 ( Bheemarao Pranesh Madakasira ) - PSG Institute of Medical Sciences and Research Department of Neurology
 ( Kumaran Senthil ) - G. Kuppuswamy Naidu Memorial Hospital Department of Imaging Services and Interventional Radiology

Abstract


Anterior surgical approaches to the cervical spinal pathology have become a frequently used technique. Anterior cervical spine surgeries are generally considered to be safe with low incidence of neurological complications. Vertebral artery (VA) injuries are infrequent during an anterior cervical spine approach but can be devastating. A retrospective review of these injuries documents an incidence of 0.3%?0.5%. However, there is no established strategy or guidelines for managing iatrogenic VA injuries. We describe a case of iatrogenic VA injury at C5 vertebral level during an anterior cervical approach for C5 cervical osteoblastoma; successful managed by endovascular coiling using detachable coils achieving complete occlusion. The patient had a good clinical outcome, with no symptoms of vertebrobasilar insufficiency at 2-year follow-up. There is a paradigm shift in the management of the VA injury after introduction of the interventional angiography. Endovascular embolization is a safe and effective treatment option, which offers certain advantages over open surgery such as minimal invasion, lower risk of neurological injury, lower morbidity, and recurrence rates.

키워드

Cervical spine; Vertebral artery transection; Endovascular embolization

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