title: Sudden cerebral infarction after interventional vertebral artery embolism for vertebral artery injury during removal of C1-C2 pedicle screw fixation: a case report.
abstract: Vertebral artery injury (VAI) is a rare but serious complication of cervical spine surgery. Instrumented posterior surgery of the upper cervical spine places the vertebral artery at the highest risk of injury. However, VAI during removal of cervical internal fixation is really rare and unexpected. We present a case of 52-year-old male patient who suffered VAI during removal of C1-C2 pedicle screw fixation. An interventional vertebral artery embolism was performed and the patient suffered a sudden cerebral infarction one day after interventional vertebral artery embolism. From this case, removal of upper cervical pedicle screws of malposition is not recommended if it is not really necessary for some other reasons. Interventional vertebral artery embolism is an effective and less invasive procedure than open ligation surgery in the treatment of haemorrhage resulted from VAI but potential risk of cerebral infarction should not be ignored.
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University Chengdu, Sichuan Province, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University Chengdu, Sichuan Province, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University Chengdu, Sichuan Province, China.
authors.forename: Litai
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University Chengdu, Sichuan Province, China.
authors.forename: Jiancheng
authors.initials: J
authors.lastname: Zeng
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University Chengdu, Sichuan Province, China.
authors.forename: Yueming
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University Chengdu, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Xie
keywords: Vertebral artery injury; cerebral infarction; cervical spine; endovascular; pedicle screw