External iliac artery occlusion in posterior spinal surgery.
METHODS
Report of a case of external iliac artery occlusion occurring as a rare complication of lumbar posterior spinal surgery.


OBJECTIVE
To clarify the cause of this rare complication and recommend methods for preventing its recurrence.


BACKGROUND
Several cases of central retinal artery occlusion after posterior spinal surgery have been reported, but there has been no reported case of external iliac artery occlusion after posterior spinal surgery.


METHODS
A 65-year-old woman who had a 32-year history of systemic lupus erythematosus underwent posterior decompression and spinal fusion for degenerative scoliosis. She was supported on a Hall frame during the operation. Three hours after surgery, paralysis and sensory impairment of the left leg and cyanosis of the toes of the left foot were noted. The popliteal, dorsalis pedis, and posterior tibial pulses were not palpable. Angiography showed complete occlusion of the external iliac artery, and emergency removal of the thrombus was performed.


RESULTS
One year later, neurologic symptoms were absent, and the leg vessels were normal.


CONCLUSIONS
Prolonged direct pressure on the inguinal region during posterior spinal surgery on a Hall frame may cause external iliac artery occlusion. Early recognition and adequate treatment can prevent serious sequelae.
Akagi
S
S
Department of Orthopedic Surgery, Kansai Medical University, Osaka, Japan.
Yoshida
Y
Y
Kato
I
I
Sasai
K
K
Saito
T
T
Imamura
A
A
Ogawa
R
R
D000368:Aged; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery; D008159:Lumbar Vertebrae / Q000601:surgery*; D011187:Posture; D012600:Scoliosis / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects*