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Vascular injury in thoracolumbar spinal surgeries and role of angiography in early diagnosis and management

Authors
 Kim, Hak Sun  ;  Chong, Hyon Su  ;  Nanda, Ankur  ;  Park, Jin Oh  ;  Moon, Seong Hwan  ;  Lee, Hwan Mo  ;  Kim, Ho Joong  ;  Park, Chun Kun  ;  Park, Ye Soo  ;  Lee, Suk Ha  ;  Moon, Eun Su 
Citation
 JOURNAL OF SPINAL DISORDERS & TECHNIQUES, Vol.23(6) : 418-424, 2010 
Journal Title
 JOURNAL OF SPINAL DISORDERS & TECHNIQUES 
ISSN
 1536-0652 
Issue Date
2010
MeSH
Adult ; Aged ; Angiography* ; Blood Vessels/injuries* ; Female ; Humans ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Orthopedic Procedures/adverse effects* ; Retrospective Studies ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/surgery* ; Vascular Diseases/diagnostic imaging* ; Vascular Diseases/etiology
Abstract
STUDY DESIGN: A retrospective outcomes study. OBJECTIVE: To stress on the importance of early diagnosis with the help of angiography and proper treatment of vascular injuries occurring during thoracolumbar surgeries and to report our results. SUMMARY OF BACKGROUND DATA: Vascular injury is a rare but dangerous complication that can develop during thoracolumbar surgeries and if not treated properly then it can lead to severe complications including the death of the patient. METHODS: The patients included in this study were the ones who were suspected to have a possible vascular injury after a thoracolumbar surgery. Contrast enhanced computed tomography was performed for patients having clinical signs suggesting vascular injury. Among these patients, who were suspected to have active bleeding and major vessel injury on computed tomography were further subjected to angiography. RESULTS: Of the 10 cases included in the study, vascular injury was identified to be arterial in origin in 8 cases and venous in 3 cases. Among the 8 cases of identified arterial injury, angiography was performed in 4 cases, of which 3 were found to have active bleeding and were subjected to immediate intervention. Of the 4 cases in which angiography was not performed, 3 of them expired at variable postoperative periods. Complications developed in total 5 cases including 3 cases of mortality, 1 case of infection, and 1 case of cauda equina syndrome. CONCLUSIONS: The vascular injuries during thoracolumbar spinal surgeries need immediate and aggressive treatment. In arterial injuries, we can prevent serious consequences by subjecting the patient to an angiography as early as possible followed by a therapeutic embolization. In contrast, for venous injuries if hemostasis has been confirmed, then an immediate intervention may not be always required
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00024720-201008000-00010&LSLINK=80&D=ovft
DOI
10.1097/BSD.0b013e3181b63f33
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Kim, Ho Joong(김호중)
Moon, Seong Hwan(문성환)
Moon, Eun Su(문은수)
Park, Jin Oh(박진오)
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
Chong, Hyon Su(정현수)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/102163
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