Complicaciones vasculares asociadas a la cirugía de columna lumbar / Vascular complications associated with lumbar spinal surgery

Hoy en día han surgido técnicas poco invasivas para tratamiento de lesiones de columna; sin embargo, la cirugía abierta todavía es requerida en muchos casos. Las lesiones vasculares ocurridas durante la cirugía de columna lumbar; si bien son infrecuentes, revisten gran importancia por su potencial gravedad. Las manifestaciones clínicas de las mismas varían desde un shock hemorrágico agudo precisando tratamiento urgente para salvar la vida del paciente, hasta lesiones de evolución insidiosa e incluso asintomáticas, que permitirían estudiar la mejor alternativa terapéutica. Presentamos cuatro casos que representan este abanico de posibilidades y que enfatizan la importancia de llevar a cabo una técnica quirúrgica minuciosa durante las intervenciones de la columna lumbar y la necesidad de una alta sospecha clínica, imprescindible para el diagnóstico temprano de estas complicaciones vasculares, a la vez que se comentan las alternativas terapéuticas disponibles en la actualidad (AU)

Although there are currently less invasive techniques available for the treatment of spinal injuries, open surgery is still required in many cases. Vascular injuries occurring during lumbar spine surgery, although uncommon, are of great importance due to their potential gravity. Clinical manifestations vary from an acute hemorrhagic shock that needs urgent treatment to save the patient's life, to insidious injuries or an asymptomatic evolution, and should be studied to choose the best therapeutic alternative. Four cases are reported that represent this range of possibilities and emphasize the importance of a careful surgical technique during lumbar spine interventions, and the need for high clinical suspicion, essential for the early diagnosis of these vascular complications. The current therapeutic options are also discussed (AU)

[Vascular complications associated with lumbar spinal surgery]. / Complicaciones vasculares asociadas a la cirugía de columna lumbar.

Although there are currently less invasive techniques available for the treatment of spinal injuries, open surgery is still required in many cases. Vascular injuries occurring during lumbar spine surgery, although uncommon, are of great importance due to their potential gravity. Clinical manifestations vary from an acute hemorrhagic shock that needs urgent treatment to save the patient's life, to insidious injuries or an asymptomatic evolution, and should be studied to choose the best therapeutic alternative. Four cases are reported that represent this range of possibilities and emphasize the importance of a careful surgical technique during lumbar spine interventions, and the need for high clinical suspicion, essential for the early diagnosis of these vascular complications. The current therapeutic options are also discussed.