Arterial injury following percutaneous vertebral augmentation: a case report.
METHODS
Case report.


OBJECTIVE
To report a case of injury to a segmental branch of the L4 lumbar artery following kyphoplasty.


BACKGROUND
To our knowledge, arterial injury following vertebral augmentation has not been described. The complications that have been reported rarely require additional intervention. The caliber of the fourth lumbar artery is such that injury to it, or to its more proximal branches, may cause significant morbidity.


METHODS
An 84-year-old female who presents 10 days after surgery from L5 kyphoplasty with pulsatile bleeding from the kyphoplasty site. An angiogram revealed an injury to a segmental branch of L4 lumbar artery.


RESULTS
A superselective angiogram was performed, followed by embolization of a branch of the L4 lumbar artery. This procedure successfully controlled the bleeding.


CONCLUSIONS
Surgeons performing percutaneous procedures for the augmentation of vertebral compression fractures are not able to visualize the arterial channels on the posterior aspect of the vertebral column. Although injury to these structures may be difficult to prevent, awareness of this complication will improve our response and decrease associated morbidity.
Biafora
Sam J
SJ
Department of Orthopaedic Surgery, University of Illinois Medical Center, Chicago, USA.
Mardjetko
Steven M
SM
Butler
Jesse P
JP
McCarthy
Patrick L
PL
Gleason
Thomas F
TF
D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D019637:Orthopedic Procedures / Q000009:adverse effects; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D014711:Vertebral Artery / Q000000981:diagnostic imaging* / Q000293:injuries*