Lim E V, Lavadia W T, Roberts J M
Department of Orthopaedic Surgery, University of Cincinnati, Ohio, USA.
Spine (Phila Pa 1976). 1996 Oct 15;21(20):2376-8. doi: 10.1097/00007632-199610150-00015.
This article reports a complication encountered when harvesting bone graft from the posterior iliac crest during a contemplated spinal fusion.
Posterior iliac crest bone grafting is commonly performed with posterior spinal instrumentation and fusion.
Review of the literature reveals a few case reports of damage through the superior gluteal artery during harvesting of bone grafts; this complication is managed with direct vessel ligation.
This article reviews the pertinent anatomy of posterior iliac crest bone grafting and addresses areas of caution important in preventing this complication.
The case report offers alternative management, that is, selective arterial embolization for hemodynamic control of the massive life-threatening bleeding that can occur with superior gluteal artery lacerations.
Injury to the superior gluteal artery is a common complication in pelvic trauma. In this patient, therapeutic arterial embolization proved to be a useful tool in controlling hemorrhage, which prevents additional bleeding problems. Superior gluteal artery injury after elective bone graft surgery is a relatively uncommon, serious, but avoidable complication. In this patient, the use of radiographically controlled arterial embolization of the lacerated vessel proved to be a quick and effective solution to this potentially life-threatening complication.
本文报告了在计划进行脊柱融合手术时从后髂嵴采集骨移植时遇到的一种并发症。
后髂嵴骨移植通常与后路脊柱内固定和融合一起进行。
文献回顾显示，有几例关于在采集骨移植过程中臀上动脉受损的病例报告；这种并发症通过直接血管结扎进行处理。
本文回顾了后髂嵴骨移植的相关解剖结构，并阐述了预防该并发症时重要的注意事项。
该病例报告提供了另一种处理方法，即对于臀上动脉撕裂可能发生的大量危及生命的出血，采用选择性动脉栓塞进行血流动力学控制。
臀上动脉损伤是骨盆创伤中的常见并发症。在该患者中，治疗性动脉栓塞被证明是控制出血的有效手段，可防止出现额外的出血问题。择期骨移植手术后的臀上动脉损伤是一种相对罕见、严重但可避免的并发症。在该患者中，对撕裂血管进行影像学控制下的动脉栓塞被证明是解决这种潜在危及生命并发症的快速有效方法。
