Abstract
Purpose: Vascular complications in lumbar disc surgery are rare, difficult to diagnose and may have serious consequences. We review our experience in eight cases treated in the past 30 years.
Methods: Between 1976 and 2005 we operated on 16,391 cases of vascular pathology, eight for vascular complications after lumbar discectomy (herniated disc), six men and two women aged 36 to 70 (mean 52 years). The symptoms were abdominal pain in four, ischial irradiation in one, episodes of heart failure in one, limb oedema in two, acute haemorrhage in three, abdominal murmur in two. The diagnosis was made during surgery in two cases and immediately postoperative in the third due to severe hypovolemia. The others were diagnosed because of abdominal murmur, limb oedema and suspected abdominal aneurism. Abdominal CT scans and arteriography were performed in five cases. Treatment was surgical, with direct closure in seven cases and interposition of a Dacron aortoiliac prosthesis in the other. No sequelae were seen during follow-up, which lasted a maximum of fifteen years. All the patients returned to normal life and there was no mortality.
Conclusions: Because of the severity and rareness of this complication, few cases have been described in the literature, and its real incidence is therefore unknown. We should think of it whenever there is any unexplained, sustained haemodynamic disorder during lumbar disc surgery or immediately postoperative. Treatment should be immediate.
The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief, Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos 108, 28015-Madrid, Spain
