Iliac vein compression syndrome from anterior perforation of a pedicle screw

Journal of Surgical Case Reports
Edward J WooDavid M Williams

Abstract

May-Thurner syndrome is an anatomic variant where the right common iliac artery compresses the left common iliac vein. The variant exists in a significant portion of the population, but is usually asymptomatic; however, clinically significant stenosis can occur by iatrogenic means. In this report, we describe a patient who presents with left lower extremity pain and swelling. Initial workup for deep vein thrombosis was negative. After being referred to our venous clinic, a magnetic resonance angiography revealed narrowing of the left common iliac vein with a tortuous right common iliac artery crossing over the constriction. During left iliac vein stent placement, a pedicle screw from a prior L2-S1 spinal fusion was noted to be perforated through L5 vertebral body impinging the posterior aspect of the vein. This case demonstrates that increased scrutiny must be applied when dealing with pathology in close proximity to any implanted medical device.

References

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Citations

May 16, 2019·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Seung-Woo SuhDong-Gune Chang
Mar 30, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Manuel Segura-TrepichioAndreu Nolasco
Jul 28, 2020·Journal of Vascular Surgery Cases and Innovative Techniques·Jeniann A YiDavid P Kuwayama
Oct 16, 2021·Joint, Bone, Spine : Revue Du Rhumatisme·Jean-Marie BerthelotChristelle Darrieutort-Laffite

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