Iliac Artery Thrombosis Due to Plaque Rupture During Performance of Anterior Lumbar Interbody Fusion: A Case Report

ABSTRACT

Anterior lumbar interbody fusion (ALIF) is a popular procedure that is used in spine surgery for treating disc herniation. Although this operation is usually safe, it can cause vascular injury, including arterial thrombosis. We report here on the case of 59-year-old woman who developed acute arterial thrombosis during ALIF. Toward the end of the operation, the somatosensory evoked potential signals decreased more than 50% in the left lower extremity, suggesting acute arterial occlusion. Therefore, a vascular surgeon was contacted and immediate thrombo-endarterectomy was performed. Thrombosis developed due to rupture of preexisting plaque during the arterial retraction. After the endarterectomy, the somatosensory evoked potentials signals and pulse were restored. To avoid vascular injury, preoperative evaluation of the vascular images and careful handling of the vessels during surgery are important. A vascular surgeon should be available not only in the event of complications, but such a surgeon should also be included from the planning of the operation.