Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Neurosurgery. 2013 Dec;73(2 Suppl Operative):ons271-81; discussion ons281-2. doi: 10.1227/01.neu.0000431468.74591.5f.
Iatrogenic vertebral artery (VA) injury is a rare but potentially devastating complication associated with cervical and craniocervical surgery.
To retrospectively evaluate treatment modalities and outcomes associated with iatrogenic VA injury.
Our institutional surgical database was queried for patients who underwent cervical or craniocervical surgery from January 1997 to August 2012.
During this time period, 8213 patients underwent cervical or craniocervical surgery, and 17 (0.2%) cases of VA injury were identified. Eight (47%) of these injuries occurred during C1-2 instrumentation procedures. Primary microsurgical repair of the VA was performed in 5 patients. Other cases were managed by either surgical or endovascular VA occlusion. Of the 17 patients, 15 underwent immediate angiography, 9 of whom were ultimately treated by the use of endovascular techniques.
VA injury is an uncommon complication of cervical and/or skull base surgery. Standardized management recommendations may help reduce complications associated with these rare but potentially devastating injuries.
医源性椎动脉（VA）损伤是一种罕见但潜在破坏性的并发症，与颈椎和颅颈手术有关。
回顾性评估与医源性 VA 损伤相关的治疗方法和结果。
我们的机构手术数据库中检索了 1997 年 1 月至 2012 年 8 月期间接受颈椎或颅颈手术的患者。
在此期间，8213 例患者接受了颈椎或颅颈手术，发现 17 例（0.2%）VA 损伤。其中 8 例（47%）发生在 C1-2 器械操作过程中。5 例患者行 VA 直接显微修复术。其他病例通过手术或血管内 VA 闭塞进行治疗。在 17 例患者中，15 例行即刻血管造影，其中 9 例最终采用血管内技术治疗。
VA 损伤是颈椎和/或颅底手术的一种罕见但潜在破坏性的并发症。标准化的管理建议可能有助于减少这些罕见但潜在破坏性损伤相关的并发症。
