Analysis of vascular injury in lumbar spine surgery

Objective: To investigate the incidence of vascular injury in lumbar spine surgery and determine the strategy for its diagnosis and treatment. Methodology: We retrospectively reviewed 1159 patients in our institution treated with lumbar spine surgery from September 2003 to November 2009. Primary outcomes measured included intraoperative vascular complications, operative blood loss and operative mortality. Results: The incidence of vascular injury is significantly higher in anterior exposure (9.1%) than posterior exposure (0.29%) (p 0.05) and 84.4% of vascular injury involved in L4-5 segment. Nineteen patients experienced vascular injury in two-level or multi-level exposure and 26 in one-level exposure, no significant difference between two groups was found (p 0.05). One patient died and others got favourable results. Conclusion: L4-5 segment has high incidence of vascular injury especially when anterior exposure is performed, and spine surgeons should pay more attention to the fatal complication.