Vertebral artery injuries in cervical spine surgery.

摘要: Abstract Background context Vertebral artery injuries (VAIs) are rare but serious complications of cervical spine surgery, with the potential to cause catastrophic bleeding, permanent neurologic impairment, and even death. The present literature regarding incidence this complication largely comprises a single surgeon or small multicenter case series. Purpose We sought gather large sample high-volume surgeons adequately characterize risk factors for VAI, management strategies used, patient outcomes after VAI. Study design study was constructed as cross-sectional comprising all patients operated on by members international Cervical Spine Research Society (CSRS). Patient All who have undergone surgery current member CSRS spring of 2012. Outcome measures For each surveyed, we collected self-reported include number cases performed in surgeon's career, VAIs encountered, stage during which injury occurred, overall outcome injury. Methods An anonymous 10-question web-based survey distributed CSRS. Statistical analysis using Student t tests numerical chi-squared categorical variables. Results One hundred forty-one (of 195 total, 72%) responded survey, accounting total 163,324 surgeries performed. VAI 0.07% (111/163,324). Posterior instrumentation upper (32.4%), anterior corpectomy (23.4%), posterior exposure (11.7%) were most common stages result an vertebral artery. Discectomy (9%) (7.2%) also time points arterial One-fifth (22/111) involved anomalous course direct tamponade. included no sequelae 90% patients, 5.5%, death 4.5%. Surgeons at academic private centers had nearly identical rates VAIs. However, 300 fewer their career 0.33% compared 0.06% those greater than lifetime (p=.028). Conclusions reported from 0.07%. Less experienced higher rate more peers. results highly variable, resulting harm time; however, occur 10% cases.