Segmental artery injury during transforaminal percutaneous endoscopic lumbar discectomy:Two case reports  

作　　者：Wan-Jae Cho Ki-Won Kim Hyung-Youl Park Bo-Hyoung Kim Jun-Seok Lee 

机构地区：[1]Department of Orthopedic Surgery,Yeouido St.Mary’s Hospital,College of Medicine,Catholic University of Korea,Seoul 07345,South Korea [2]Department of Orthopedic Surgery,Eunpyeong St.Mary’s Hospital,College of Medicine,Catholic University of Korea,Seoul 03312,South Korea

出　　处：《World Journal of Clinical Cases》2022年第33期12345-12351,共7页世界临床病例杂志

摘　　要：BACKGROUND Since Kambin experimentally induced arthroscopy to treat herniated nucleus pulposus,percutaneous endoscopic lumbar discectomy(PELD)has been developed.The branch of the segmental artery around the neural foramen may be damaged during PELD using the transforaminal approach.We report 2 rare cases in which segmental artery injury that occurred during PELD was treated with emergency embolization.CASE SUMMARY In case 1,a 31-year-old man was transferred to our emergency department with left lower quadrant abdominal pain after PELD at a local hospital.Lumbar spine magnetic resonance imaging after the surgery showed a hematoma of the left retroperitoneal area and the psoas muscle area.Under suspicion of vascular injury,arteriography was performed.Pseudoaneurysm and blood leakage from the left 4th lumbar segmental artery into the abdominal cavity were identified.Emergency transarterial embolization was performed using fibered microcoils for bleeding of the segmental artery.In case 2,a 75-year-old woman was transferred to our emergency department with low blood pressure,right flank pain,and drowsy mental status after PELD at a local hospital.When the patient arrived at the emergency room,the blood pressure decreased from 107/55 mmHg to 72/47 mmHg.Low blood pressure persisted.Under suspicion of vessel injury,arteriography was performed,and the right 4th lumbar segmental artery rupture was confirmed.Emergency transarterial embolization was performed for bleeding of segmental artery.CONCLUSION We were able to find the bleeding focus by angiography and treat the injury of the segmental artery successfully through emergency transarterial embolization.

关 键 词：Percutaneous endoscopic lumbar discectomy Segmental artery injury Transarterial embolization ANGIOGRAPHY Case report 

分 类 号：R687.3[医药卫生—骨科学]