VASCULAR COMPLICATIONS OF LUMBAR DISC SURGERY

Over a period of seven years nine patients with vascular complications after lumber discectomy received medical care at the Clinic of Vascul ar Surgery. University of Graz Medical School. We report five acute bl eeding complications occurring during the operation and four late mani festations of vascular lesions. Five patients presented with acute lif e-threatening iatrogenic haemorrhages from pelvic vessels. Three patie nts made a complete recovery, one patient died from acute haemorrhagic shock, one further patient died from species due to an associated com plication - an injury to the ureter. Over a period of two to ten years after primary surgery we corrected late complications such as 1 case of posttraumatic aneurysm of the aortic bifurcation found to have erod ed the body of the fifth lumbar vertebra, and three cases of arteriove nous fistula between the common iliac artery and the common iliac vein . The four casts described below are an attempt to document the vascul ar surgical procedures involved and to provide typical findings. The r isk of injuring the pelvic vessels intra-operatively can be explained by the close anatomical relation between the retroperitoneal vessels a nd the vertebral column and furthermore not only by the fact that pre- existent deficiencies but also injury to the anterior longitudinal lig ament give access to the retroperitoneal space.