+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Vertebral artery injury in cervical spine surgery



Vertebral artery injury in cervical spine surgery



Instructional Course Lectures 58: 717-728



Vertebral artery injuries during cervical spine surgery are rare, with a reported incidence of 0.3% to 0.5%. The vertebral artery enters the vertebral foramen most commonly at C6 and courses from anterior and lateral to medial and posterior with respect to the vertebral body up to C3. The vertebral artery has a more variable course in the atlantoaxial region. Careful assessment on preoperative imaging will identify common anomalies and help avoid a vertebral artery injury. If a vertebral artery injury occurs, rapid action is required to prevent exsanguination or catastrophic neurologic injury. Every attempt should be made to repair the vertebral artery because the contralateral artery may not provide sufficient blood flow in this spondylotic population. If repair is not possible and contralateral circulation is deemed adequate, endovascular coiling or primary ligation should be performed. Tamponade should be avoided as the definitive treatment because of well-known complications.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 056863660

Download citation: RISBibTeXText

PMID: 19385580


Related references

Indirect vertebral artery injury during cervical spine surgery. Canadian Journal of Anaesthesia 53(7): 738-739, 2006

Iatrogenic vertebral artery injury during anterior cervical spine surgery. Spine Journal 5(5): 508, 2005

Anatomic basis of the anterior surgery on the cervical spine: relationships between uncus-artery-root complex and vertebral artery injury. Surgical and Radiologic Anatomy 20(6): 389-392, 1998

"Iatrogenic vertebral artery injury during anterior cervical spine surgery", by Dr. Burke JP, et al. Spine Journal 3(1): 89; Author Reply 89, 2003

Vertebral artery injury during cervical spine surgery: a survey of more than 5600 operations. Spine 33(7): 779-785, 2008

Risks for Vascular Injury During Anterior Cervical Spine Surgery: Prevalence of a Medial Loop of Vertebral Artery and Internal Carotid Artery. Spine 41(4): 293-298, 2016

Epidemiology of Iatrogenic Vertebral Artery Injury in Cervical Spine Surgery: 21 Multicenter Studies. World Neurosurgery 126: E1050-E1054, 2019

Iatrogenic Vertebral Artery Injury During Anterior Cervical Spine Surgery: A Systematic Review. World Neurosurgery 106: 715-722, 2017

Vertebral artery injury during foraminal decompression in "low-risk" cervical spine surgery: incidence and management. Acta Neurochirurgica 157(11): 1941-1945, 2015

Vertebral artery injury in cervical spine surgery: anatomical considerations, management, and preventive measures. Spine Journal 9(1): 70-76, 2008

Direct Damage to a Vertebral Artery Better Predicts a Vertebral Artery Injury than Elongation in Cervical Spine Dislocation. Acta Medica Okayama 71(5): 427-432, 2017

Unilateral vertebral artery injury in a patient with displaced upper cervical spine fractures: the treatment for one case of vertebral artery embolism. European Spine Journal 27(Suppl 3): 409-414, 2018

Epidemiology and Outcomes of Vertebral Artery Injury in 16 582 Cervical Spine Surgery Patients: An AOSpine North America Multicenter Study. Global Spine Journal 7(1 Suppl): 21s-27s, 2017

Endovascular embolization of iatrogenic vertebral artery injury during anterior cervical spine surgery: report of two cases and review of the literature. Spine 31(23): E891-E894, 2006

Tortuous vertebral artery injury complicating anterior cervical spinal fusion in a symptomatic rheumatoid cervical spine. Spine 29(16): E343-E348, 2004