Vertebral artery injury during cervical spine surgery: a survey of more than 5600 operations

Spine
Masashi NeoTakashi Nakamura

Abstract

Retrospective survey. To clarify the present incidence and management of iatrogenic vertebral artery injury (VAI) during cervical spine surgery. VAI is a rare complication of cervical spine surgery, but it may be catastrophic. Anterior cervical decompression (ACD) and posterior atlantoaxial transarticular screw fixation (Magerl fixation) have been the main causes, with reported incidences of 0.3% to 0.5% and 0% to 8.2%, respectively. Popular new surgical techniques, such as cervical pedicle screw or C1 lateral mass screw fixation, also entail the potential risk of VAI. A questionnaire was sent to our affiliated hospitals requesting information regarding iatrogenic VAI during cervical spine surgery. Seven spine surgeon groups and 25 general orthopedist groups responded to the questionnaire, with a response rate of 89%. The overall incidence of VAI was 0.14% (8 cases among 5641 cervical spine surgeries). The incidence in anterior cervical decompression procedures was 0.18% and that in Magerl fixation was 1.3%. Inexperienced surgeons tended to commit VAI more frequently. One case of VAI during C1 lateral mass screw fixation was included, whereas there was no case of VAI caused by cervical pedicle screw fixation. In the case of "VA...Continue Reading

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Citations

Dec 31, 2010·Surgical and Radiologic Anatomy : SRA·Daniel Hölbling PatscheiderHelga Fritsch
Apr 2, 2009·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·Hiromu ItoTakashi Nakamura
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Jul 14, 2012·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·Hyung-Ki Park, Hae-Dong Jho
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