Although rare, neurologic injuries associated with infrarenal aortic a
nd iliac artery surgery are devastating and associated with high morta
lity and morbidity. The authors reviewed their ten-year experience wit
h 738 infrarenal aortic and iliac artery aneurysm repairs, 341 aortoil
iac bypasses for occlusive disease, and 15 reoperations for infected a
ortic prosthesis to identify patients who suffered lower extremity neu
rologic deficits. Three patients, all following ruptured aneurysms, su
ffered injuries to the lumbosacral plexus during the study period. No
injuries to the spinal cord were diagnosed. These cases are described,
and the diagnosis, prognosis, and potential etiologies and prevention
are discussed.