Eva. Lim et al., SUPERIOR GLUTEAL ARTERY INJURY DURING ILIAC BONE-GRAFTING FOR SPINAL-FUSION - A CASE-REPORT AND LITERATURE-REVIEW, Spine (Philadelphia, Pa. 1976), 21(20), 1996, pp. 2376-2378
Study Design. This article reports a complication encountered when har
vesting bone graft from the posterior iliac crest during a contemplate
d spinal fusion.Objectives. Posterior iliac crest bone grafting is com
monly performed with posterior spinal instrumentation and fusion. Summ
ary of Background Data. Review of the literature reveals a few case re
ports of damage through the superior gluteal artery during harvesting
of bone grafts; this complication is managed with direct vessel ligati
on. Methods. This article reviews the pertinent anatomy of posterior i
liac crest bone grafting and addresses areas of caution important in p
reventing this complication. Results. The case report offers alternati
ve management, that is, selective arterial embolization for hemodynami
c control of the massive life-threatening bleeding that can occur with
superior gluteal artery lacerations. Conclusions. Injury to the super
ior gluteal artery is a common complication in pelvic trauma. In this
patient, therapeutic arterial embolization proved to be a useful tool
in controlling hemorrhage, which prevents additional bleeding problems
. Superior gluteal artery injury after elective bone graft surgery is
a relatively uncommon, serious, but avoidable complication. In this pa
tient, the use of radiographically controlled arterial embolization of
the lacerated vessel proved to be a quick and effective solution to t
his potentially life-threatening complication.