Vertebral Artery Injury During Cervical Discectomy and Fusion in a Patient With Bilateral Anomalous Arteries in the Disc Space: Case Report
Vertebral Artery Injury During Cervical Discectomy and Fusion in a Patient With Bilateral Anomalous Arteries in the Disc Space: Case Report
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椎间盘间隙双侧异常动脉患者颈椎间盘切除融合术中的椎动脉损伤：病例报告
DOI：
10.1227/01.neu.0000374858.18717.33
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发表时间：
2010
期刊：
影响因子：
4.8
通讯作者：
W. White
中科院分区：
文献类型：
--
作者：
Brian R. Gantwerker;A. Baaj;P. Maughan;C. McDougall;W. White
我们的目标是提高颈椎前路椎间盘切除术的安全性，这是一种在全世界神经外科医生面对椎动脉（VA）异常时进行的常规手术。临床表现一名59岁女性患者在C3 - 7择期颈椎前路椎间盘切除术和融合术中左侧VA损伤。回顾性分析她的磁共振图像显示双侧异常VA。术后干预，出现假性动脉瘤，随后进行了弹簧圈栓塞。患者接受了假性动脉瘤栓塞，并通过血管内神经外科技术牺牲载瘤血管。她没有神经后遗症，但确实有一些吞咽困难。结论放射科医生、神经放射科医生和外科医生在常规评估颈椎磁共振图像时应注意VA的位置和进程。神经放射科医生应提醒外科医生注意异常VA的可能性，这些VA在手术过程中有损伤的风险。最终，外科医生仍有责任仔细审查图像，评估血管异常，并相应地计划手术。
OBJECTIVEOur goal was to increase the safety of anterior cervical discectomy, a routine surgery performed by neurosurgeons worldwide, in the face of vertebral artery (VA) anomalies. CLINICAL PRESENTATIONA 59-year-old woman had an intraoperative injury of the left VA during elective anterior cervical discectomy and fusion from C3 to 7. Retrospective analysis of her magnetic resonance images showed bilateral anomalous VAs. Intervention postoperatively, a pseudoaneurysm developed that was subsequently coiled. The patient underwent embolization of the pseudoaneurysm and sacrifice of the parent vessel by endovascular neurosurgical techniques. She had no neurological sequelae but did have some difficulty swallowing. CONCLUSIONRadiologists, neuroradiologists, and surgeons should note the location and course of the VA in their routine evaluation of cervical magnetic resonance images. Neuroradiologists should alert surgeons to the possibility of anomalous VAs that are at risk of injury during surgery. Ultimately, it remains the responsibility of the surgeon to carefully review the images, assess for vascular anomalies, and plan the surgery accordingly.