Vertebral Artery Injury in C2-3 Epidural Schwannoma Resection: A Case Report and Literature Review.
Vertebral Artery Injury in C2-3 Epidural Schwannoma Resection: A Case Report and Literature Review.
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DOI：
10.13004/kjnt.2017.13.1.39
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发表时间：
2017-04
影响因子：
--
通讯作者：
Rhim SC
中科院分区：
文献类型：
--
作者：
Lee SB;Rhim CH;Roh SW;Jeon SR;Rhim SC
椎动脉损伤在后路肿瘤切除术中发生率极低，但可导致严重的并发症。在这个病例中，一位57岁的男性接受了手术切除肿瘤，涉及左侧硬膜外腔和神经孔在C2-3水平。在使用垂体钳进行肿瘤切除术时突然发生医源性VAI。立即进行局部止血和维持灌注以降低后循环缺血的风险。同时进行VA和紧急捕获栓塞的术中血管造影。它可以降低术后即刻并发症的风险，并进一步延迟发生。通过适当的术中处理，患者在VAI后无并发症。术前血管造影检查和血管内团队合作的准备是非常必要的，也是颈椎手术期间VAI的警告。
The incidence of vertebral artery (VA) injury (VAI) in posterior approach tumor resection surgery is extremely rare, but it can lead to serious complication. In this case, a 57-year-old man underwent surgery for resection of the tumor involving left epidural space and neural foramen at C2-3 level. Iatrogenic VAI occurred suddenly during tumor resection procedure using pituitary forceps. Immediate local hemostasis and maintaining of perfusion for reducing the risk of posterior circulation ischemia were performed. Intraoperative angiogram of both VA and emergent trapping embolization were done as well. It may reduce the risk of immediate postop complication, and further delayed occurrence. The patient had no complication after VAI by appropriate intraoperative management. Preoperative angiographic work up and preparation of endovascular team cooperation are positively necessary as well as a warning for the VAI during cervical spine surgery.