VASCULAR INJURY DURING LUMBAR DISC SURGERY - REPORT OF 2 CASES - A REVIEW OF THE LITERATURE

Iatrogenic vascular injuries are unusual complications of lumbar disc surgery. The incidence of such injuries is very low but probably under estimated because clinical manifestations may be extremely variable de pending on the extension of trauma. Diagnosis is suspected when early signs of retroperitoneal haemorrhage appear, but may often be delayed for weeks or pears due to formation of a pseudoaneurysm or an arteriov enous fistula which may be of gradual onset and produce initially only a few symptoms. Prompt diagnosis and aggressive treatment can improve the current mortality rare of more than 50%. Two cases are described that illustrate the full spectrum of acute and chronic manifestations of such injuries. One case of acute haemorrhage due to arterial trauma was immediately detected and the other case with arteriovenous fistul a was recognized several years post-operatively.