Late-onset bowel perforation and iliac artery erosion after prominent anterior spinal instrumentation.
METHODS
Case report.


OBJECTIVE
To report a rare complication of anterior spine surgery and instrumentation.


BACKGROUND
Anterior spinal fusion and instrumentation are now frequently used for the treatment of a variety of complex spinal disorders. Several authors have discussed the complications of such procedures. Late perforation of large bowel along with erosion of major vessel after anterior spinal instrumentation is a rare occurrence.


METHODS
We present a case of 53-year-old woman who presented with unusual abdominal pain and bleeding of the rectum. She had undergone spine surgery for L5 burst fracture 5 years ago. A detailed evaluation showed perforation of rectosigmoid colon and erosion of left common iliac artery by the anterior spine implants.


RESULTS
The bowel was repaired and arterial reconstruction was done along with spine implant removal. The patient had complete recovery of symptoms after the treatment.


CONCLUSIONS
Delayed visceral injury with anterior spine surgeries is rare. Early diagnosis is possible with a high degree of suspicion. Meticulous surgical techniques may avoid this complication.
Department of Spine Surgery, MIOT Hospitals, Chennai, Tamil Nadu, India. ishkee004@gmail.com
Ishwara
I
Keerthi
C S
CS
Dhillon
Mrinal B
MB
Shetty
D012809:Colon, Sigmoid / Q000293:injuries*; D020878:Device Removal; D013505:Digestive System Surgical Procedures; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D007083:Iliac Artery / Q000293:injuries*; D016268:Internal Fixators / Q000009:adverse effects; D007416:Intestinal Perforation / Q000209:etiology* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008875:Middle Aged; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D057772:Vascular System Injuries / Q000209:etiology* / Q000601:surgery