Abstract
Purpose
Description of a case of direct intraoperative lesion and repair of a major vascular injury of common iliac vein during an extreme lateral interbody fusion L4–L5 procedure.
Methods
A 69-year-old female who was operated for L4–L5 spondilolysthesis suffered a major vascular injury of a vein. The high cava bifurcation and inadequate pre-operative analysis of the radiological documentation resulted in the lesion. The lesion was successfully repaired and the patient did not suffer post-operative sequelae.
Results
The repair was successful although the index spine procedure was not ended. Detailed pre-operative planning, based on radiological examination of vascular structures, should be a mandatory step prior to this specific surgical approach.
Conclusion
Although safer than anterior retroperitoneal approach, extreme lateral interbody fusion still bears risk for major vascular injury.
This is a preview of subscription content, log in via an institution to check access.
References
Ozgur BM, Aryan HE, Pimenta L, Taylor WR (2006) Extreme Lateral Interbody Fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J 6:435–443
Billinghurst J, Akbarnia BA (2009) Extreme lateral interbody fusion—XLIF. Curr Orthop Pract 20:238–251
Santillan A, Patsalides A, Gobin YP (2010) Endovascular embolization of iatrogenic lumbar artery pseudoaneurysm following extreme lateral interbody fusion (XLIF). Vasc Endovasc Surg 44:601–603
Assina R, Majmundar NJ, Herschman Y, Heary RF (2014) First report of major vascular injury due to lateral transpsoas approach leading to fatality: case report. J Neurosurg Spine 21:794–798
Kueper J, Fantini GA, Walker BR, Aichmair A, Hughes AP (2015) Incidence of vascular complications during lateral lumbarinterbody fusion: an examination of the mini-open access technique. Eur Spine J. doi:10.1007/s00586-015-3796-2
Faciszewski T, Winter RB, Lonstein JE, Denis F, Johnson L (1995) The surgical and medical perioperative complications of anterior spinal fusion surgery in the thoracic and lumbar spine in adults: a review of 1223 procedures. Spine 20:1592–1599
Rajaraman V, Vingan R, Roth P, Heary RF, Conklin L, Jacobs GB (1999) Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg 91:60–64
Fantini GA, Pappou IP, Girardi FP, Sandhu HS, Cammisa FP Jr (2007) Major vascular injury during anterior lumbar spinal surgery: incidence, risk factors, and management. Spine 32:2751–2758
Wood KB, DeVine J, Fischer D, Dettori JR, Janssen M (2010) Vascular injury in elective anterior lumbosacral surgery. Spine 35:S66–S75
Brau SA, Delamarter RB, Schiffman ML, Williams LA, Watkins RG (2004) Vascular injury during anterior lumbar surgery. Spine J 4:409–412
Pirró N, Ciampi D, Champsaur P, Di Marino V (2005) The anatomical relationship of the iliocava junction to the lumbosacral spine and the aortic bifurcation. Surg Radiol Anat 27:137–141
Harmon PH (1964) A simplified surgical technic for anterior lumbar diskectomy and fusion; avoidance of complications; anatomy of the retroperitoneal veins. Clin Orthop Relat Res 37:130–144
Vidal V, Monnet O, Jacquier A, Bartoli JM, Tropiano P (2010) Accessory iliac vein: surgical implications. J Spinal Disord Tech 23(6):398–403
Timberlake GA, Kerstein MD (1995) Venous injury: to repair or ligate, the dilemma revisited. Am Surg 61(2):139–145
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflict of interest.
Rights and permissions
About this article
Cite this article
Buric, J., Bombardieri, D. Direct lesion and repair of a common iliac vein during XLIF approach. Eur Spine J 25 (Suppl 1), 89–93 (2016). https://doi.org/10.1007/s00586-015-4134-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-015-4134-4