title: Somatosensory-evoked potential monitoring detects iliac artery occlusion during posterior spinal fusion.
abstract: METHODS
  Report of a rare case of iliac artery occlusion occurring during posterior spinal surgery.
  
  
  OBJECTIVE
  To clarify causes of an acute occlusion of iliac vessels during posterior spinal surgery.
  
  
  BACKGROUND
  Acute embolic occlusion of the iliac artery is a medical and surgical emergency. Iatrogenic occlusion of major vessels to the lower extremities during posterior lumbar spine operation is a rare entity.
  
  
  METHODS
  We report this complication occurring during decompression and fusion in a 55-year-old female with history of diabetes, hyperlipidemia, and multivessels vascular disease. The application of somatosensory evoked potentials during this case detected an asymmetry of cortical responses due to low blood flow to the affected limb.
  
  
  RESULTS
  This patient underwent endovascular intervention and placement of stents to restore the flow to the limbs.
  
  
  CONCLUSIONS
  It is feasible to assume that continuous and direct pressure on the inguinal region during surgery on Jackson table was the primary cause of the iliac artery occlusion, particularly in these patients with known peripheral vascular disease. Early recognition and prompt vascular intervention can prevent serious sequelae.
authors: Clinical Neurodiagnostic Department, Sharp Memorial Hospital, San Diego, CA 92123, USA. siavash.haghighi@sharp.com
authors: Siavash S
authors: SS
authors: Haghighi
authors: Zhang
authors: Z
authors: Richard
authors: Bertha
authors: B
authors: Ramirez
mesh_terms: D000208:Acute Disease; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D019299:Decompression, Surgical; D048909:Diabetes Complications; D004198:Disease Susceptibility; D004617:Embolism / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D004630:Emergencies; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D007083:Iliac Artery / Q000601:surgery; D007383:Intermittent Claudication / Q000209:etiology; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D007796:Laminectomy; D007866:Leg / Q000098:blood supply; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D058638:Operating Tables; D056888:Patient Positioning; D016491:Peripheral Vascular Diseases / Q000150:complications; D011312:Pressure; D013003:Somatosensory Cortex / Q000503:physiopathology; D013123:Spinal Fusion; D015607:Stents