Vertebral artery injury during cervical discectomy and fusion in a patient with bilateral anomalous arteries in the disc space: Case report

Brian R. Gantwerker, Mhd-Ali - Baaj, Peter H. Maughan, Cameron G. McDougall, William L. White

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: Our goal was to increase the safety of anterior cervical discectomy, a routine surgery performed by neurosurgeons worldwide, in the face of vertebral artery (VA) anomalies. Clinical presentation: A 59-year-old woman had an intraoperative injury of the left VA during elective anterior cervical discectomy and fusion from C3 to 7. Retrospective analysis of her magnetic resonance images showed bilateral anomalous VAs. Intervention postoperatively, a pseudoaneurysm developed that was subsequently coiled. The patient underwent embolization of the pseudoaneurysm and sacrifice of the parent vessel by endovascular neurosurgical techniques. She had no neurological sequelae but did have some difficulty swallowing. Conclusion: Radiologists, neuroradiologists, and surgeons should note the location and course of the VA in their routine evaluation of cervical magnetic resonance images. Neuroradiologists should alert surgeons to the possibility of anomalous VAs that are at risk of injury during surgery. Ultimately, it remains the responsibility of the surgeon to carefully review the images, assess for vascular anomalies, and plan the surgery accordingly.

Original languageEnglish (US)
JournalNeurosurgery
Volume67
Issue number3
DOIs
StatePublished - Sep 2010
Externally publishedYes

Fingerprint

Diskectomy
Vertebral Artery
Arteries
False Aneurysm
Wounds and Injuries
Magnetic Resonance Spectroscopy
Endovascular Procedures
Deglutition
Blood Vessels
Safety
Surgeons

Keywords

  • Pseudo aneurysm
  • Spine
  • Vertebral artery injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Vertebral artery injury during cervical discectomy and fusion in a patient with bilateral anomalous arteries in the disc space : Case report. / Gantwerker, Brian R.; Baaj, Mhd-Ali -; Maughan, Peter H.; McDougall, Cameron G.; White, William L.

In: Neurosurgery, Vol. 67, No. 3, 09.2010.

Research output: Contribution to journalArticle

Gantwerker, Brian R. ; Baaj, Mhd-Ali - ; Maughan, Peter H. ; McDougall, Cameron G. ; White, William L. / Vertebral artery injury during cervical discectomy and fusion in a patient with bilateral anomalous arteries in the disc space : Case report. In: Neurosurgery. 2010 ; Vol. 67, No. 3.
@article{0de63db902b340b9b49119f99fc41e36,
title = "Vertebral artery injury during cervical discectomy and fusion in a patient with bilateral anomalous arteries in the disc space: Case report",
abstract = "Objective: Our goal was to increase the safety of anterior cervical discectomy, a routine surgery performed by neurosurgeons worldwide, in the face of vertebral artery (VA) anomalies. Clinical presentation: A 59-year-old woman had an intraoperative injury of the left VA during elective anterior cervical discectomy and fusion from C3 to 7. Retrospective analysis of her magnetic resonance images showed bilateral anomalous VAs. Intervention postoperatively, a pseudoaneurysm developed that was subsequently coiled. The patient underwent embolization of the pseudoaneurysm and sacrifice of the parent vessel by endovascular neurosurgical techniques. She had no neurological sequelae but did have some difficulty swallowing. Conclusion: Radiologists, neuroradiologists, and surgeons should note the location and course of the VA in their routine evaluation of cervical magnetic resonance images. Neuroradiologists should alert surgeons to the possibility of anomalous VAs that are at risk of injury during surgery. Ultimately, it remains the responsibility of the surgeon to carefully review the images, assess for vascular anomalies, and plan the surgery accordingly.",
keywords = "Pseudo aneurysm, Spine, Vertebral artery injury",
author = "Gantwerker, {Brian R.} and Baaj, {Mhd-Ali -} and Maughan, {Peter H.} and McDougall, {Cameron G.} and White, {William L.}",
year = "2010",
month = "9",
doi = "10.1227/01.NEU.0000374858.18717.33",
language = "English (US)",
volume = "67",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Vertebral artery injury during cervical discectomy and fusion in a patient with bilateral anomalous arteries in the disc space

T2 - Case report

AU - Gantwerker, Brian R.

AU - Baaj, Mhd-Ali -

AU - Maughan, Peter H.

AU - McDougall, Cameron G.

AU - White, William L.

PY - 2010/9

Y1 - 2010/9

N2 - Objective: Our goal was to increase the safety of anterior cervical discectomy, a routine surgery performed by neurosurgeons worldwide, in the face of vertebral artery (VA) anomalies. Clinical presentation: A 59-year-old woman had an intraoperative injury of the left VA during elective anterior cervical discectomy and fusion from C3 to 7. Retrospective analysis of her magnetic resonance images showed bilateral anomalous VAs. Intervention postoperatively, a pseudoaneurysm developed that was subsequently coiled. The patient underwent embolization of the pseudoaneurysm and sacrifice of the parent vessel by endovascular neurosurgical techniques. She had no neurological sequelae but did have some difficulty swallowing. Conclusion: Radiologists, neuroradiologists, and surgeons should note the location and course of the VA in their routine evaluation of cervical magnetic resonance images. Neuroradiologists should alert surgeons to the possibility of anomalous VAs that are at risk of injury during surgery. Ultimately, it remains the responsibility of the surgeon to carefully review the images, assess for vascular anomalies, and plan the surgery accordingly.

AB - Objective: Our goal was to increase the safety of anterior cervical discectomy, a routine surgery performed by neurosurgeons worldwide, in the face of vertebral artery (VA) anomalies. Clinical presentation: A 59-year-old woman had an intraoperative injury of the left VA during elective anterior cervical discectomy and fusion from C3 to 7. Retrospective analysis of her magnetic resonance images showed bilateral anomalous VAs. Intervention postoperatively, a pseudoaneurysm developed that was subsequently coiled. The patient underwent embolization of the pseudoaneurysm and sacrifice of the parent vessel by endovascular neurosurgical techniques. She had no neurological sequelae but did have some difficulty swallowing. Conclusion: Radiologists, neuroradiologists, and surgeons should note the location and course of the VA in their routine evaluation of cervical magnetic resonance images. Neuroradiologists should alert surgeons to the possibility of anomalous VAs that are at risk of injury during surgery. Ultimately, it remains the responsibility of the surgeon to carefully review the images, assess for vascular anomalies, and plan the surgery accordingly.

KW - Pseudo aneurysm

KW - Spine

KW - Vertebral artery injury

UR - http://www.scopus.com/inward/record.url?scp=77956188087&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956188087&partnerID=8YFLogxK

U2 - 10.1227/01.NEU.0000374858.18717.33

DO - 10.1227/01.NEU.0000374858.18717.33

M3 - Article

C2 - 20657320

AN - SCOPUS:77956188087

VL - 67

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 3

ER -