External iliac artery occlusion in posterior spinal surgery

Study Design. Report of a case of external iliac artery occlusion occurring as a rare complication of lumbar posterior spinal surgery. Objective, To clarify the cause of this rare complication and recommend met hods for preventing its recurrence, Summary of Background Data. Several cases of central retinal artery occlusi on after posterior spinal surgery have been reported, but there has been no reported case of external iliac artery occlusion after posterior spinal su rgery. Methods. A 65-year-old woman who had a 32-year history of systemic lupus er ythematosus underwent posterior decompression and spinal fusion for degener ative scoliosis. Site was supported on a Hall frame during the operation. T hree hours after surgery, paralysis and sensory impairment of the left leg acid cyanosis of the toes of the left foot were noted. The popliteal, dorsa lis pedis, and posterior tibial pulses were not palpable. Angiography showe d complete occlusion of the external iliac artery, end emergency removal of the thrombus was performed. Results. One year later, neurologic symptoms were absent, and the leg vesse ls were normal. Conclusions. Prolonged direct pressure on the inguinal region during poster ior spinal surgery on a Hall frame may cause external iliac artery occlusio n. Early recognition and adequate treatment can prevent serious sequelae.