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Review
. 2022 Apr 19;18(1):34-44.
doi: 10.13004/kjnt.2022.18.e20. eCollection 2022 Apr.

Epidemiology and Management of Iatrogenic Vertebral Artery Injury Associated With Cervical Spine Surgery

Ho Jun Yi  1
Affiliations
Review

Epidemiology and Management of Iatrogenic Vertebral Artery Injury Associated With Cervical Spine Surgery

Ho Jun Yi. Korean J Neurotrauma. .

Abstract

Iatrogenic vertebral artery injury (VAI) caused by surgical interventions involving the cervical spine is an uncommon but catastrophic complication associated with high morbidity or mortality due to ischemic stroke, intra- or extra-dural hemorrhage, and the formation of pseudoaneurysm or arteriovenous fistulae. In cervical spine surgeries, VAI may occur during the peri- or postoperative period. This may be induced by an anterior or posterior surgical approach. Despite advanced imaging techniques and increased anatomical knowledge, VAI during cervical spinal surgery remains a challenge. Techniques for managing VAI include hemostatic tamponade, ligation, microvascular repair or anastomosis, and endovascular management. We need to consider the risk of iatrogenic VAI as a complication in patients undergoing cervical spine surgeries and a better understanding of its mechanism and proper management.

Keywords: Cervical spine; Infarction, Surgery; Vertebral artery injury.

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Conflict of interest statement

Conflict of Interest: The author has no financial conflicts of interest.

Figures

FIGURE 1
FIGURE 1. Flow sheet for management of iatrogenic vertebral artery injury in cervical spine surgeries.
AVF: arteriovenous fistula, CTA: computed tomography angiography, MRA: magnetic resonance angiography, VAI: vertebral artery injury.
See this image and copyright information in PMC

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References

    1. Abumi K, Shono Y, Ito M, Taneichi H, Kotani Y, Kaneda K. Complications of pedicle screw fixation in reconstructive surgery of the cervical spine. Spine (Phila Pa 1976) 2000;25:962–969. - PubMed
    1. Afana HB, Abuhadrous NMM, Elsharkawy AE. Bithalamic infarction (artery of percheron occlusion) after anterior cervical discectomy and fusion. Case Rep Neurol Med. 2019;2019:9438089. - PMC - PubMed
    1. An TY, Kang DH, Kim DH. Anastomosis and endovascular treatment of iatrogenic vertebral artery injury. Korean J Neurotrauma. 2021;17:204–211. - PMC - PubMed
    1. Burke JP, Gerszten PC, Welch WC. Iatrogenic vertebral artery injury during anterior cervical spine surgery. Spine J. 2005;5:508–514. - PubMed
    1. Carl B, Bopp M, Pojskic M, Voellger B, Nimsky C. Standard navigation versus intraoperative computed tomography navigation in upper cervical spine trauma. Int J CARS. 2019;14:169–182. - PubMed