scholarly journals Endovascular Treatment of Vertebral Artery Injury during Cervical Posterior Fusion (C1 Lateral Mass Screw)

2013 ◽  
Vol 19 (3) ◽  
pp. 370-376 ◽  
Author(s):  
Kyeong-Wook Yoon ◽  
Jung-Ho Ko ◽  
Chun-Sung Cho ◽  
Sang-Koo Lee ◽  
Young-Joon Kim ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Vertebral Artery Injury ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Endovascular Technique ◽  
Massive Blood Loss ◽  
Artery Injury ◽  
Posterior Cervical Fusion ◽  
C1 Lateral Mass Screw

We describe two cases of vertebral artery injury during posterior cervical fusion. We treated both cases by an endovascular technique. The vertebral artery injury may result in catastrophic situations, such as, infarction, massive blood loss and even death. Our clinical outcome was good and we prove that endovascular treatment is an effective and less invasive way to treat vertebral artery injury.

Vertebral artery injury in C-1 lateral mass screw fixation

2006 ◽  
Vol 5 (6) ◽  
pp. 554 ◽  
Author(s):  
Yoichi Aota ◽  
Atsushi Honda ◽  
Masaaki Uesugi ◽  
Takayuki Yamashita ◽  
Noriyuki Baba ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Screw Fixation ◽  
Vertebral Artery Injury ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Artery Injury

Civilian gunshot wounds to the atlantoaxial spine: a report of 10 cases treated using a multidisciplinary approach

2013 ◽  
Vol 19 (6) ◽  
pp. 759-766 ◽  
Author(s):  
Peter Syre ◽  
Leonardo Rodriguez-Cruz ◽  
Rajiv Desai ◽  
Karl A. Greene ◽  
Robert Hurst ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Operative Treatment ◽  
Anticoagulation Therapy ◽  
Vascular Complications ◽  
Gunshot Wounds ◽  
Vertebral Artery Injury ◽  
Treatment Modalities ◽  
Acute Management ◽  
Lateral Mass ◽  
Artery Injury

Object Gunshot wounds to the atlantoaxial spine are uncommon injuries and rarely require treatment, as a bullet traversing this segment often results in a fatal injury. Additionally, these injuries are typically biomechanically stable. The authors report a series of 10 patients with gunshot wounds involving the lateral mass and/or bodies of the atlantoaxial complex. Their care is discussed and conclusions are drawn from these cases to identify the optimal treatment for these injuries. Methods A retrospective review was conducted of patients presenting to the emergency rooms of 3 institutions with gunshot wounds involving the atlantoaxial spine. Mechanism of injury and neurological status were obtained, as was the extent of the osteoligamentous, vascular, and neurological injuries. Nonoperative and operative treatment, complications, and clinical and radiographic outcome were recorded. The data were then analyzed to determine the neurological and biomechanical prognosis of these injuries, the utility of the various diagnostic modalities in the acute management of the injuries, and the nature and effectiveness of the nonoperative and operative treatment modalities. Results Ten patients with gunshot wounds involving the lateral mass and/or bodies of the atlantoaxial complex were identified. All but 2 patients sustained a vertebral artery injury. Each patient was evaluated using cervical radiographs, CT scans, and vascular imaging, 8 in the form of digital subtraction angiography and 2 with high-resolution CT angiography. Uncomplicated patients were treated conservatively using cervical collar immobilization, local wound care, and antibiotics. One patient was treated using a halo for instability and 1 underwent posterior fusion following a posterolateral decompression for delayed myelopathy. One patient underwent transoral resection of a bullet fragment. One patient underwent embolization for a symptomatic arteriovenous fistula and a second patient underwent a neck exploration and a jugular vein ligation. None of the patients received anticoagulation therapy. The mean follow-up duration was 13 months. All but 2 patients regained their previous functional status and all ultimately attained a mechanically stable spine. Conclusions These 10 patients represent a rare form of cervical spine penetrating injury. Unilateral gunshot wounds to the atlantoaxial complex are usually stable and the need for acute surgical intervention is rare. Unilateral vertebral artery injury is well tolerated and any information provided by angiography does not alter the acute management of the patient. Vascular complications from gunshot wounds can be managed effectively by endovascular techniques.

Rate and Characteristics of Vertebral Artery Injury Following C1-C2 Posterior Cervical Fusion: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 148 ◽  
pp. 118-126
Author(s):  
Abdul Karim Ghaith ◽  
Yagiz U. Yolcu ◽  
Mohammed Ali Alvi ◽  
Archis R. Bhandarkar ◽  
Arjun S. Sebastian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vertebral Artery ◽  
Meta Analysis ◽  
Vertebral Artery Injury ◽  
Cervical Fusion ◽  
Artery Injury ◽  
Posterior Cervical Fusion

Emergency Endovascular Treatment of a Penetrating Vertebral Artery Injury with Detachable Coils

2005 ◽  
Vol 18 (1) ◽  
pp. 117-121
Author(s):  
H. Akan ◽  
K. Atalay ◽  
Ü. Belet ◽  
Z. Özmen ◽  
S. Gelmez
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Surgical Approach ◽  
Stab Wound ◽  
Active Bleeding ◽  
Vertebral Artery Injury ◽  
Left Vertebral Artery ◽  
Artery Injury ◽  
Bony Canal ◽  
Detachable Coils

The surgical approach is difficult and time-consuming in cases of injury to the bony canal segment of the vertebral artery. Diagnosis and treatment should be performed urgently if the patient has active bleeding. We present a patient with a left vertebral artery injury in a stab wound to the neck in whom emergency endovascular treatment was performed with detachable coils because of ongoing gross bleeding.

Individualized endovascular treatment of high-grade traumatic vertebral artery injury

2014 ◽  
Vol 156 (9) ◽  
pp. 1781-1788 ◽  
Author(s):  
Qiyong Mei ◽  
Mingxing Sui ◽  
Wenze Xiao ◽  
Zhengwang Sun ◽  
Rulin Bai ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Vertebral Artery Injury ◽  
High Grade ◽  
Artery Injury ◽  
Traumatic Vertebral Artery Injury

Navigation-Guided Subaxial Cervical Pedicle Screws in Revision Spine Surgery: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Jennifer Z Mao ◽  
Justice O Agyei ◽  
Moleca M Ghannam ◽  
Asham Khan ◽  
Marc Christensen ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Vertebral Artery ◽  
Pedicle Screws ◽  
Vertebral Artery Injury ◽  
Lateral Mass ◽  
Artery Injury ◽  
Cord Injury ◽  
Cervical Pedicle ◽  
Cervical Pedicle Screws

Abstract Traditionally, lateral mass screws (LMSs) have been the mainstay of posterior fixation in the subaxial spine. Although LMSs provide adequate fixation, cervical pedicle screws (CPSs) facilitate high fusion rates (90.5%) and provide for greater bone purchase, better reduction, lower rates of screw loosening or pull out, 2 times greater biomechanical advantage, superior stabilization, decreased development of pseudarthrosis, and decreased revision surgeries compared to LMSs.1-4 In addition, CPSs can be a powerful bail-out option after lateral mass construct failure. Navigation-guided CPS placement has been reported to have an accuracy of 90.3%.5 Navigation has the added advantage of mitigating screw malposition for the placement of CPS because of the smaller pedicle sizes and variability in cervical anatomy.1,3,6 The potential risks of subaxial CPS placement include the risks of vertebral artery injury, spinal cord injury, and injury to adjacent neurovasculature.2 The overall radiographic breach rate with intraoperative imaging is reported to range from 2.9% of 22.9%, with the majority of breaches occurring in the lateral direction.7,8 Despite radiographic breaches, the occurrence of nerve root injury (0.31% per screw), vertebral artery injury (0.15% per screw), and spinal cord injury (0% per screw) is rare.3,7 Here, we demonstrate navigation-assisted C1-C2 posterior fusion, with combined C1 LMSs and C2 pedicle screws with subaxial pedicle screw revision of prior failed instrumentation.3  The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary.

Vertebral Artery Pseudoaneurysm Resulting in Embolic Stroke as a Complication of Posterior C1 Lateral Mass Screw Fixation

2013 ◽  
Vol 3 (3) ◽  
pp. e93
Author(s):  
Danielle Y. Ponzio ◽  
Alexander R. Vaccaro ◽  
James S. Harrop ◽  
Robert J. Ponzio ◽  
Christopher K. Kepler ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Screw Fixation ◽  
Embolic Stroke ◽  
Lateral Mass ◽  
Lateral Mass Screw ◽  
Artery Pseudoaneurysm ◽  
C1 Lateral Mass Screw
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