Wangqin Runqi, Xu Kaya, Mokin Maxim, Uribe Juan, Rojas Haydy, Ren Zeguang
Department of Neurology, Duke University Medical Center, Durham, North Carolina, USA.
Department of Neurological Surgery, University of South Florida, Tampa, Florida, USA.
World Neurosurg. 2019 Feb;122:282-286. doi: 10.1016/j.wneu.2018.10.217. Epub 2018 Nov 9.
Iatrogenic vertebral artery injury is an uncommon but well recognized complication during cervical spine surgery. Intraoperative surgical repair is extremely challenging, and options for endovascular repair are limited because of the lack of proper equipment in the operating room setting.
A 53-year-old woman who presented with myelopathy underwent anterior cervical diskectomy and fusion of C3-7. A significant laceration injury of the left vertebral artery was encountered during surgery, which was salvaged by intraoperative endovascular repair with a covered stent under portable fluoroscopy guidance. The salvage and repair led to the rest of the surgery being finished as planned preoperatively without any consequences.
Vertebral artery injury is an uncommon but severe complication of cervical spine surgery. For uncontrolled bleeding, intraoperative endovascular repair with portable fluoroscopy is warranted and possible. A covered stent can seal the laceration and stop the bleeding completely which enables completion of the surgery.
医源性椎动脉损伤是颈椎手术中一种罕见但已被充分认识的并发症。术中手术修复极具挑战性，由于手术室环境中缺乏合适的设备，血管内修复的选择有限。
一名53岁出现脊髓病的女性接受了C3 - 7颈椎前路椎间盘切除术和融合术。手术过程中遇到左侧椎动脉严重撕裂伤，在便携式荧光透视引导下通过术中血管内修复并使用覆膜支架进行了挽救。挽救和修复使得手术的其余部分按术前计划完成，没有任何不良后果。
椎动脉损伤是颈椎手术中一种罕见但严重的并发症。对于无法控制的出血，术中使用便携式荧光透视进行血管内修复是必要且可行的。覆膜支架可以封闭撕裂口并完全止血，从而使手术能够完成。
