+ 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 injuries in cervical spine surgery



Vertebral artery injuries in cervical spine surgery



Surgical Neurology International 4(Suppl 5): S362



Vertebral artery injuries during cervical spine surgery are rare, but potentially fatal. When performing cervical spine surgery, it is imperative that the surgeon has a systematic approach for avoiding, and if necessary, dealing with a vertebral artery injury. This is a review paper. Upper posterior cervical spine surgeries put the vertebral artery at the highest risk, as opposed to anterior subaxial cervical spine procedures, which put the artery at the least risk. A thorough understanding of the complex anatomy of the vertebral artery is mandatory prior to performing cervical spine surgery, and since the vertebral artery can have a variable course, especially in the upper cervical spine, the surgeon must minimize the possibility of an arterial injury by preoperatively assessing the artery with a computed tomography (CT) scan or magnetic resonance imaging (MRI). Intraoperatively, the surgeon must be aware of when the vertebral artery is most at risk, and take precautions to avoid an injury. In the event of an arterial injury, the surgeon must have a plan of action to (1) Achieve control of the hemorrhage. (2) Prevent acute central nervous system ischemia. (3) Prevent postoperative complications such as embolism and pseudoaneurysm. Prior to performing cervical spine surgery, one must understand the four A's of vertebral artery injuries: Anatomy, Assessment, Avoidance, and Action.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 060462048

Download citation: RISBibTeXText

PMID: 24340233


Related references

Vertebral artery injuries in cervical spine surgery. Spine Journal 14(8): 1520-1525, 2014

Esophageal and vertebral artery injuries during complex cervical spine surgery--avoidance and management. Orthopedic Clinics of North America 43(1): 63, 2012

Vertebral artery injuries associated with cervical spine injuries: a review of the literature. Journal of Spinal Disorders and Techniques 21(4): 252-258, 2008

Cervical spine injuries and compression of the vertebral artery. Neurochirurgia 21(4): 122-127, 1978

Risk factors for vertebral artery injuries in cervical spine trauma. Orthopedic Reviews 6(3): 5429, 2014

Closed cervical spine trauma associated with bilateral vertebral artery injuries. Archives of Orthopaedic and Trauma Surgery 119(7-8): 478-481, 1999

Injuries to the cervical spine causing vertebral artery trauma: case reports. Journal of Trauma 31(1): 127-133, 1991

Vertebral artery injuries following chiropractic cervical spine manipulation case reports. Angiology 41(6): 445-452, 1990

Vertebral artery injuries following cervical spine trauma: a prospective observational study. European Spine Journal 20(12): 2202-2209, 2011

The vertebral artery and cervical spine surgery. Annales de Radiologie 23(4): 241-244, 1980

Vertebral artery injury in cervical spine surgery. Instructional Course Lectures 58: 717-728, 2009

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

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

Long-term evaluation of vertebral artery injuries following cervical spine trauma using magnetic resonance angiography. Spine 23(7): 789, 1998

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