Diagnosis and management of an intraoperative vertebral artery injury

A patient with cervical myelopathy caused by marked degenerative alteration s of the cervical spinal column at the level of cervical vertebrae 3/4 and relative spinal canal stenosis in the area of cervical vertebrae 5-7 was tr eated in the department of neurosurgery because of progressive myatrophy an d paresis of muscles innervated from cervical nerves 5-7. The operation was performed with vertebrectomy of cervical vertebra 6, implantation of a Har ms titanium cage with autograft and a plate and spongy bone screw fixation system. There exists an unusual - and not often publicized - complication d uring this surgical procedure in the area of the cervical spine, namely pen etrating injury of the vertebral artery caused by the treatment with a plat e and spongy bone screw fixation system. We describe such an injury of the left vertebral artery. The vertebral artery was intraoperatively embolized using mechanical embolization coils.