Successful Treatment of Internal Iliac Vein Rupture During Revisional Anterior Lumbar Spinal Surgery Using a Tack - Case Report -

Sangbong Ko; Taebum Oh; Kihyuk Park

doi:10.4184/jkss.2017.24.2.115

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Ko, Oh, and Park: Successful Treatment of Internal Iliac Vein Rupture During Revisional Anterior Lumbar Spinal Surgery Using a Tack - Case Report -

Case Report

Journal of Korean Spine Surg 2017;24(2):115-120.

Published online: 30 June 2017

DOI: https://doi.org/10.4184/jkss.2017.24.2.115

Successful Treatment of Internal Iliac Vein Rupture During Revisional Anterior Lumbar Spinal Surgery Using a Tack - Case Report -

Sangbong Ko, M.D., Taebum Oh, M.D., Kihyuk Park, M.D.^∗

Department of Orthopaedic Surgery, Daegu Catholic University Medical Center, Daegu, Korea

^∗Department of General Surgery, Daegu Catholic University Medical Center, Daegu, Korea

Corresponding author: Sangbong Ko, M.D. ORCID ID: 0000-0003-3527-9251 Department of Orthopedic Surgery, Daegu Catholic University Hospital, Path 33, 17 Duryu Park Road, Nam-gu, Daegu, City, Korea TEL: +82-53-650-4283, FAX: +82-53-626-4272 E-mail: bong@cu.ac.kr

Received 30 March 20175 April 2017 Accepted 1 June 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Case report.

Objectives

To report a rare case in which a tack was used to control bleeding due to a torn iliac vein during revisional anterior spine surgery.

Summary of Literature Review

During anterior lumbar surgery, bleeding following a vascular injury is possible to control and reparable in most cases. During revisional anterior lumbar surgery, however, there are irreparable cases of bleeding as well. In some cases, it can threaten the patient's life.

Material and Methods

A 56-year-old man suffered from potentially fatal bleeding following iliac vein rupture during revisional anterior lumbar surgery. Primary vascular closure was impossible due to severe adhesion. We attempted to stop the venous bleeding with a tack, as an alternative treatment. The potentially fatal bleeding was controlled and the patient's vital signs stabilized after hemostasis by the tack.

Results

Hemostasis using the tack saved the patient's life without any rebleeding.

Conclusions

During revisional anterior lumbar surgery, bleeding following an iliac vein rupture can be controlled by a tack in cases that are irreparable due to severe adhesion.

Keywords: Iliac vein, Rupture, Anterior lumbar surgery, Bleeding control

REFERENCES

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8. Chiriano J, Abou-Zamzam AM Jr, Urayeneza O, et al. The role of the vascular surgeon in anterior retroperitoneal spine exposure: preservation of open surgical training. J Vasc Surg. 2009; 50:148–51.

9. Ariyoshi D, Sano S, Kawamura N. Inferior vena cava injury caused by an anteriorly migrated cage resulting in ligation: case report. J Neurosurg Spine. 2016; 24:409–12.

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Fig. 1.

(A) A sagittal image of the lumbar spine and (B) an axial image at L5-S1 show a left herniated disc in preoperative magnetic resonance imaging. (C) Coronal images and (D) sagittal images show decompressed lamina and posterior interbody fusion in postoperative imaging.

Fig. 2.

(A) A coronal image, (B) a sagittal image, (C) an extension image, and (D) a flexion image show a displaced cage and non-fused findings at the L5-S1 level 1 year after the operation.

Fig. 3.

A sagittal image of the lumbar spine shows a displaced cage and non-fused findings at the L5-S1 level in computed tomography.

Fig. 4.

The tack is shown maintaining its position well in (A) a coronal image and (B) a sagittal image obtained 3 days after the operation. Axial computed tomography images show acute venous thrombotic occlusion in images obtained 7 days postoperatively.

Fig. 5.

(A) A coronal image and (B) a sagittal image obtained 1 year after the operation show the tack maintaining its position well.

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