title: Giant delayed pseudo-aneurysm following screw placement in C1 lateral mass.
abstract: We report the case of a patient who suffered iatrogenic vertebral artery injury (VAI) during a cervical spine posterior fixation procedure. The patient suffered massive bleeding and hemorrhagic shock at the time of screws placement in C1 lateral mass and C2 pedicle. The postoperative MRI and CT angiography showed a pseudoaneurysm 7.0 cm in diameter in the cervical spine. The iatrogenic VAI during posterior screw fixation is extremely rare. But, it can cause catastrophic consequences. We discuss the causes for the iatrogenic VAI and review the preventative measures and suitable management to avoid iatrogenic complications.
authors.affiliation: Department of spine, Shanghai East Hospital, 150#Jimo Road, Pudong New Area, Shanghai 200120, China.
authors.forename: S
authors.initials: S
authors.lastname: Guo
authors.affiliation: Department of spine, Shanghai East Hospital, 150#Jimo Road, Pudong New Area, Shanghai 200120, China.
authors.forename: J
authors.initials: J
authors.lastname: Pan
authors.affiliation: Department of spine, Shanghai East Hospital, 150#Jimo Road, Pudong New Area, Shanghai 200120, China.
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of spine, Shanghai East Hospital, 150#Jimo Road, Pudong New Area, Shanghai 200120, China.
authors.forename: M
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of spine, Shanghai East Hospital, 150#Jimo Road, Pudong New Area, Shanghai 200120, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of spine, Shanghai East Hospital, 150#Jimo Road, Pudong New Area, Shanghai 200120, China.
authors.forename: J
authors.initials: J
authors.lastname: Wen
authors.affiliation: Department of spine, Shanghai East Hospital, 150#Jimo Road, Pudong New Area, Shanghai 200120, China.
authors.forename: M
authors.initials: M
authors.lastname: Fan
authors.affiliation: Department of spine, Shanghai East Hospital, 150#Jimo Road, Pudong New Area, Shanghai 200120, China. Electronic address: tanjuntj2012@163.com.
authors.forename: J
authors.initials: J
authors.lastname: Tan
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis*; D001863:Bone Screws / Q000009:adverse effects; D002574:Cervical Vertebrae / Q000293:injuries / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications; D008279:Magnetic Resonance Imaging; D061330:Multidetector Computed Tomography; D011183:Postoperative Complications; D016103:Spinal Fractures / Q000601:surgery*; D014711:Vertebral Artery / Q000473:pathology*; D020217:Vertebral Artery Dissection / Q000209:etiology
keywords: Complication; Iatrogenic vascular injury; Pseudoaneurysm; Spinal instrumentation; Verterbral artery injury