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Summary of Key Clinical Information on Iliac Vessel Injuries During Spinal Surgery
| Aspect | Details |
|---|---|
| Incidence & Severity | Rare but potentially fatal, with a reported incidence of 0.04% and mortality rates between 15–60%. |
| Common Injuries | Iliac artery and vein injuries are common, with risks of laceration, arteriovenous fistulas, and pseudoaneurysms. |
| Clinical Presentation | Symptoms range from immediate hemorrhagic shock to asymptomatic progression. In the presented case, postoperative hemorrhagic shock occurred with a hemoglobin drop to 35g/l. |
| Diagnostic Approach | Utilization of MSCT angiography is critical for identifying active bleeding and vascular lesions. |
| Surgical Intervention | Emergency surgery often necessary; techniques include direct suturing and graft interposition (e.g., 8mm Dacron graft for iliac artery reconstruction in the case study). |
| Risk Factors | Previous surgeries, close proximity of the disc to major vessels, and intraoperative challenges such as excessive instrument intrusion and inadequate positioning. |
| Management Strategies | Vigilant peri- and postoperative monitoring is vital due to the risk of delayed massive bleeding. Both endovascular and open surgical interventions are viable depending on the scenario. |