Document Detail


Vertebral artery injury in cervical spine surgery.
MedLine Citation:
PMID:  19385580     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Vertebral artery injuries during cervical spine surgery are rare, with a reported incidence of 0.3% to 0.5%. The vertebral artery enters the vertebral foramen most commonly at C6 and courses from anterior and lateral to medial and posterior with respect to the vertebral body up to C3. The vertebral artery has a more variable course in the atlantoaxial region. Careful assessment on preoperative imaging will identify common anomalies and help avoid a vertebral artery injury. If a vertebral artery injury occurs, rapid action is required to prevent exsanguination or catastrophic neurologic injury. Every attempt should be made to repair the vertebral artery because the contralateral artery may not provide sufficient blood flow in this spondylotic population. If repair is not possible and contralateral circulation is deemed adequate, endovascular coiling or primary ligation should be performed. Tamponade should be avoided as the definitive treatment because of well-known complications.
Authors:
Clinton J Devin; James D Kang
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Instructional course lectures     Volume:  58     ISSN:  0065-6895     ISO Abbreviation:  Instr Course Lect     Publication Date:  2009  
Date Detail:
Created Date:  2009-04-23     Completed Date:  2009-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7507149     Medline TA:  Instr Course Lect     Country:  United States    
Other Details:
Languages:  eng     Pagination:  717-28     Citation Subset:  IM    
Affiliation:
Fondren Orthopedic Group, Houston, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Angiography, Digital Subtraction
Cervical Vertebrae / injuries,  pathology,  surgery*
Humans
Preoperative Care
Tomography, X-Ray Computed
Vertebral Artery / injuries*,  pathology,  surgery*

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


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