Document Detail


Far lateral disc excision at L5-S1 complicated by iliolumbar artery incursion: case report.
MedLine Citation:
PMID:  11383746     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE AND IMPORTANCE: Paramedial approaches to far lateral discs at the L5-S1 space joint have advantages but may also bring the surgical space closer to large branch arteries of the internal iliac artery. I report incursion into an iliolumbar artery that required laparotomy to control hemorrhage. Surgeons performing extraforaminal disc explorations at L5-S1 need to evaluate preoperative magnetic resonance imaging scans for an enlarged iliolumbar artery near the disc space. CLINICAL PRESENTATION: The patient presented with a right L5 radiculopathy and a far lateral disc at L5-S1, as indicated by analysis of her magnetic resonance imaging scan. INTERVENTION: A midline incision and an extraforaminal exposure were performed. Arterial bleeding occurred when an anular disc fragment was removed with a pituitary rongeur under direct vision with microscopic magnification. Emergency laparotomy demonstrated hemorrhage from a branch of the internal iliac artery 2 cm from its origin. CONCLUSION: Iliolumbar artery variants may be at the margins of extraforaminal disc exposure at L5-S1. Preoperative magnetic resonance imaging scans should be evaluated for this vasculature structure.
Authors:
J F Harrington
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  48     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-05-31     Completed Date:  2001-10-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1377-9; discussion 1379-80     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Brown University School of Medicine, Providence, Rhode Island.
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MeSH Terms
Descriptor/Qualifier:
Adult
Emergency Medical Services
Female
Hemorrhage / etiology*,  surgery
Humans
Iliac Artery / injuries*
Intervertebral Disk / surgery*
Intervertebral Disk Displacement / surgery*
Intraoperative Complications / etiology,  surgery
Laparotomy
Lumbar Vertebrae*
Sacrum*
Wounds, Penetrating / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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