A fatal iatrogenic right vertebral injury after transoral odontoidectomy and posterior cervical stabilization for a type II odontoid fracture.
The authors present a singular case of an iatrogenic right vertebral artery injury, involving a 67 year-old man, who reported a type II odontoid fracture (Anderson and D'Alonzo Classification) and posterior atlantoaxial dislocation following a road traffic accident. A small injury involving the right vertebral artery occurred as a consequence of transoral odontoidectomy and posterior cervical stabilization. It was caused by bone spicules of spinal origin and their presence was confirmed by the histological section of the right vertebral artery at the level of C1-C2. The case confirms how iatrogenic vertebral artery injuries during cervical spine surgery may be potentially lethal, especially where complications arise some days after surgery.
Department of Biopathology, Medical and Forensic Biotechnology, Section of Legal Medicine, University of Palermo, Italy.
Edoardo
E
Scalici
Department of Anatomy, Biology and Genetics, Legal Medicine, Neurosciences, Diagnostic Pathology, Hygiene and Public Health, "G. F. Ingrassia", Section of Legal Medicine, University of Catania, Via S. Sofia, 87 - Comparto 10, 95123 Catania, Italy.
Francesca
F
Indorato
Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", Section of Human Pathology, University of Palermo, Italy.
Francesca
F
Portelli
Department of Biopathology, Medical and Forensic Biotechnology, Section of Legal Medicine, University of Palermo, Italy.
Tommaso
T
Savì
Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", Section of Human Pathology, University of Palermo, Italy.
Emiliano
E
Maresi
Department of Anatomy, Biology and Genetics, Legal Medicine, Neurosciences, Diagnostic Pathology, Hygiene and Public Health, "G. F. Ingrassia", Section of Legal Medicine, University of Catania, Via S. Sofia, 87 - Comparto 10, 95123 Catania, Italy. Electronic address: fra.busardo@libero.it.
Francesco P
FP
Busardò
D000063:Accidents, Traffic; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000473:pathology; D001268:Atlanto-Axial Joint / Q000293:injuries / Q000601:surgery; D002560:Cerebrovascular Circulation; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods; D017809:Fatal Outcome; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology; D007049:Iatrogenic Disease; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D009809:Odontoid Process / Q000293:injuries / Q000601:surgery*; D010020:Osteonecrosis / Q000473:pathology; D016103:Spinal Fractures / Q000145:classification / Q000601:surgery*; D013927:Thrombosis / Q000473:pathology; D014711:Vertebral Artery / Q000293:injuries* / Q000473:pathology
Odontoid fracture; Transoral odontoidectomy; Vertebral artery injury