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经皮清醒机器人辅助骶髂关节融合术后臀上动脉破裂假性动脉瘤的成功弹簧圈栓塞:病例说明

Successful coil embolization of a ruptured pseudoaneurysm of the superior gluteal artery after a percutaneous awake robot-assisted sacroiliac joint fusion: illustrative case.

作者信息

Morsi Samah, Bartlett Alyssa M, Hardigan Andrew A, Paturu Mounica, Adams Shawn W, DeBaun Malcolm R, Pabon-Ramos Waleska, Abd-El-Barr Muhammad M

机构信息

Departments of1Neurosurgery.

2Orthopedic Surgery, and.

出版信息

J Neurosurg Case Lessons. 2024 Apr 8;7(15). doi: 10.3171/CASE2413.

DOI:10.3171/CASE2413
PMID:38588592
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11007270/
Abstract

BACKGROUND

Robot-assisted sacroiliac joint (SIJ) fusion has gained popularity, but it carries the risk of complications such as injury to the superior gluteal artery (SGA). The authors present the case of an awake percutaneous robot-assisted SIJ fusion leading to an SGA pseudoaneurysm.

OBSERVATIONS

An 80-year-old male, who had undergone an awake percutaneous robot-assisted SIJ fusion, experienced postoperative left hip pain and bruising. Subsequent arteriography demonstrated an SGA branch pseudoaneurysm requiring coil embolization.

LESSONS

An SGA injury, although uncommon (1.2% incidence), can arise from percutaneous screw placement, aberrant anatomy, or hardware contact. Thorough preoperative imaging, precise robot-assisted screw insertion, and soft tissue protection are crucial to mitigate risks. Immediate angiography aids in prompt diagnosis and effective intervention. Comprehensive knowledge of anatomical variants is essential for managing complications and optimizing preventative measures in robot-assisted SIJ fusion.

摘要

背景

机器人辅助骶髂关节(SIJ)融合术已逐渐普及,但存在诸如损伤臀上动脉(SGA)等并发症的风险。作者报告了一例清醒状态下经皮机器人辅助SIJ融合术导致SGA假性动脉瘤的病例。

观察结果

一名80岁男性接受了清醒状态下经皮机器人辅助SIJ融合术,术后出现左髋部疼痛和瘀斑。随后的血管造影显示SGA分支假性动脉瘤,需要进行弹簧圈栓塞。

经验教训

SGA损伤虽不常见(发生率为1.2%),但可能由经皮螺钉置入、解剖结构异常或硬件接触引起。术前进行全面的影像学检查、精确的机器人辅助螺钉置入以及软组织保护对于降低风险至关重要。立即进行血管造影有助于及时诊断和有效干预。全面了解解剖变异对于处理机器人辅助SIJ融合术中的并发症和优化预防措施至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/b530688759d9/CASE2413f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/34bf23a23a91/CASE2413f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/10852f849ab4/CASE2413f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/e48ea9abc333/CASE2413f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/0ebab35d5332/CASE2413f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/b530688759d9/CASE2413f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/34bf23a23a91/CASE2413f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/10852f849ab4/CASE2413f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/e48ea9abc333/CASE2413f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/0ebab35d5332/CASE2413f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d427/11007270/b530688759d9/CASE2413f5.jpg

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