Vascular complications of lumbar decompression laminectomy and foraminotomy. A unique case and review of the literature.
The possibility of vascular injury should always be kept in mind during lumbar laminectomy. Patients with pre-existing vascular disease are predisposed to injury. Unexplained hypotension is highly suggestive of a vascular catastrophe and is an indication for more detailed examination, sometimes laparotomy. If the patient's clinical condition is stable, consider arteriography. The development of high-output cardiac failure in a patient who has recently undergone lumbar laminectomy is almost diagnostic of traumatic arteriovenous fistula. The best prognosis for recovery of acute vascular interruption occurs with immediate treatment within 24-48 hours. Continued awareness of the possible occurrence of these injuries and familiarity with their various manifestations will facilitate early diagnosis, prompt operative repair, and improved mortality.
Smith
D W
DW
Department of Orthopedic Surgery, Doctors Hospital, Stark County, Massillon, Ohio.
Lawrence
B D
BD
D001158:Arteries / Q000293:injuries; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space; D013130:Spinal Stenosis / Q000601:surgery