Multimodality Management of Vertebral Artery Injury Sustained During Cervical or Craniocervical Surgery

Department

neurosurgery

Document Type

Article

Abstract

BACKGROUND: Iatrogenic vertebral artery (VA) injury is a rare but potentially devastating complication associated with cervical and craniocervical surgery. OBJECTIVE: To retrospectively evaluate treatment modalities and outcomes associated with iatrogenic VA injury. METHODS: Our institutional surgical database was queried for patients who underwent cervical or craniocervical surgery from January 1997 to August 2012. RESULTS: During this time period, 8213 patients underwent cervical or craniocervical surgery, and 17 (0.2%) cases of VA injury were identified. Eight (47%) of these injuries occurred during C1-2 instrumentation procedures. Primary microsurgical repair of the VA was performed in 5 patients. Other cases were managed by either surgical or endovascular VA occlusion. Of the 17 patients, 15 underwent immediate angiography, 9 of whom were ultimately treated by the use of endovascular techniques. CONCLUSION: VA injury is an uncommon complication of cervical and/or skull base surgery. Standardized management recommendations may help reduce complications associated with these rare but potentially devastating injuries. Copyright © 2013 by the Congress of Neurological Surgeons.

Publication Date

2013

Publication Title

Neurosurgery

ISSN

0148-396X

Volume

73

Issue

2

First Page

ons271

Last Page

ons281

Digital Object Identifier (DOI)

10.1227/01.neu.0000431468.74591.5f

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