Department of Neurosurgery, CHU University Hospital Center, Université Catholique de Louvain (UCL), Yvoir, Namur, Belgium.
Department of Vascular Surgery, CHU University Hospital Center, Université Catholique de Louvain (UCL), Yvoir, Namur, Belgium.
World Neurosurg. 2020 May;137:372-375. doi: 10.1016/j.wneu.2020.02.028. Epub 2020 Feb 11.
Venous stenting is a common treatment for chronic peripheral venous disease. The most frequent complications caused by this technique are stent misplacement and intracardiac or intravascular stent migration. In this publication, we will describe the first case of an intraspinal stent misplacement leading to lumbar nerve root compression.
Our patient was a 20-year-old woman with a bilateral pulmonary embolism caused by a right common iliac vein thrombosis and a severe compression of the left common iliac vein by the right common iliac artery (May-Thurner or Cockett syndrome). She underwent an endovascular stenting of the left iliac vein. A few days later, she reported some pain in the right L5 radicular and showed signs of hypoesthesia of the left leg and of paresis of the left extensor hallucis longus muscle. A lumbar computed tomography scan showed a stent misplacement into the spinal canal through the left L5 foramen with nerve root compression. She underwent a surgical removal of the stent through a unilateral L5-S1 laminarthrectomy. The postoperative follow-up showed a complete clinical recovery and a control lumbar computed tomography scan confirmed the L5 nerve root decompression.
The intraspinal misplacement of a venous stent is a rare complication that may cause nerve root injury. It requires a prompt treatment. Surgically removing the stent by a posterior approach seems to be a simple and safe therapeutic option.
静脉支架置入术是治疗慢性周围静脉疾病的常用方法。该技术最常见的并发症是支架位置不当以及心内或血管内支架迁移。在本出版物中，我们将描述首例导致腰椎神经根受压的椎管内支架错位病例。
我们的患者是一名 20 岁女性，因右侧髂总静脉血栓形成导致双侧肺栓塞，左侧髂总静脉严重受压于右侧髂总动脉（May-Thurner 或 Cockett 综合征）。她接受了左侧髂静脉的血管内支架置入术。几天后，她报告右侧 L5 神经根出现疼痛，并出现左腿感觉减退和左足背伸肌无力的迹象。腰椎 CT 扫描显示支架通过左侧 L5 椎间孔错位进入椎管并压迫神经根。她接受了单侧 L5-S1 椎板切除术的支架取出手术。术后随访显示完全临床康复，腰椎 CT 扫描证实 L5 神经根减压。
静脉支架的椎管内错位是一种罕见的并发症，可能导致神经根损伤。需要及时治疗。通过后路手术取出支架似乎是一种简单且安全的治疗选择。
