Prevention, Management, and Monitoring of Vertebral Artery Injuries. Current State of Knowledge of Spine Surgeons in Argentina
Main Article Content
Abstract
Materials and Methods: An observational descriptive study was carried out through a survey transmitted through AANC and SAPCV.
Results: Of 157 responses, 47.4% consider it relevant to evaluate the anatomy of the vertebral artery in all types of pathology by angiographic methods. Half of those surveyed diagnosed an anatomical variant of the artery, 29.2% reported having encountered an artery injury during their practice and only 35% had an action protocol for the management of this adverse event. 77% adopted tamponade as their first measure. In the postoperative follow-up, the majority of surgeons studied the final state of the situation using angiographic methods. Around 10% would try to establish some measure of antithrombotic prophylaxis. 76.6% have an hemodynamics service with an endovascular surgeon.
Conclusion: We found an underestimation of this complication. Less than half of surgeons routinely use diagnostic tools for possible anatomical changes. Management or monitoring protocols for these injurieshave not been observed.
Downloads
Metrics
Article Details
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
References
Management of Intraoperative Vertebral Artery Lacerations, 2020. Dissertation. Disponible en: https://aovideos.
aofoundation.org/media/lng=en/1_f9bv2m7y?_ga=2.106769415.52853214.1641727860-1224076216.1632358289
2. Hsu WK, Kannan A, Mai, HT, Fehlings MG, Smith ZA, Traynelis VC, et al. Epidemiology and outcomes of
vertebral artery injury in 16 582 cervical spine surgery patients: An AOSpine North America Multicenter Study.
Global Spine J 2017;7(1 suppl):21S-27S. https://doi.org/10.1177/2192568216686753
3. Neo M, Fujibayashi S, Miyata M, Takemoto M, Nakamura T. Vertebral artery injury during cervical spine surgery: a survey of more than 5600 operations. Spine (Phila PA 1976) 2008;33(7):779-85. https://doi.org/10.1097/BRS.0b013e31816957a7
4. Lunardini DJ, Eskander MS, Even JL, Dunlap JT, Chen AF, Lee JY, et al. Vertebral artery injuries in cervical spine
surgery. Spine J 2014;14(8):1520-5. https://doi.org/10.1016/j.spinee.2013.09.016
5. Eskander MS, Jacob MD, Aubin ME, Marvin J, Franklin PD, Eck JC, et al. Vertebral artery anatomy. A review of
two hundred fifty magnetic resonance imaging scans. Spine (Phila PA 1976) 2010;35(23):2035-40.
https://doi.org/10.1097/BRS.0b013e3181c9f3d4
6. Lee SH, Park DH, Kim SD, Huh DS, Kim KT. Analysis of 3-dimensional course of the intra-axial vertebral artery
for C2 pedicle screw trajectory: a computed tomographic study. Spine (Phila Pa 1976) 2014;39(17):E1010-4.
https://doi.org/10.1097/BRS.0000000000000418
7. Sano A, Hirano T, Watanabe K, Izumi T, Endo N, Ito T, Inagawa S. Preoperative evaluation of the vertebral arteries and posterior portion of the circle of Willis for cervical spine surgery using 3-dimensional computed tomography angiography. Spine (Phila Pa 1976) 2013;38(15):E960-7. https://doi.org/10.1097/BRS.0b013e318296e542
8. Wakao N, Takeuchi M, Nishimura M, Riew KD, Kamiya M, Hirasawa A, et al. Risks for vascular injury during
anterior cervical spine surgery: prevalence of a medial loop of vertebral artery and internal carotid artery. Spine
(Phila PA 1976) 2016;41(4):293-8. https://doi.org/10.1097/BRS.0000000000001241
9. Young JP, Young PH, Ackermann MJ, Anderson PA, Riew KD. The ponticulus posticus: implications for screw
insertion into the first cervical lateral mass. J Bone Joint Surg Am 2005;87(11): 2495-8. https://doi.org/10.2106/JBJS.E.00184
10. Choi B, Granero R, Pak A. Catalog of bias in health questionnaires. Rev Costarr Salud Pública 2010;19:106-18.
Disponible en: https://www.scielo.sa.cr/scielo.php?pid=S1409-14292010000200008&script=sci_arttext&tlng=en