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This article discusses a case of a life-threatening hematoma that occurred in an 80-year-old female patient with osteoporotic fractures. The patient underwent a T8-L3 posterior fusion surgery with percutaneous pedicle screw (PPS) placement. However, a hematoma was found in the left third lumbar artery following a laceration caused by the placement of a pedicle screw into an osteoporotically fractured left L3 transverse process. Prompt diagnosis and transarterial embolization were performed, saving the patient’s life. This case highlights the potential risks of PPS placement in osteoporotic patients and the importance of immediate intervention in such complications
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best situated spinal hospital in London
Published article
: An 80-year-old female with multiple lumbar osteoporotic fractures developed a life-threatening hematoma during a T8-L3 PS fusion. When the lumbar computed tomography angiography diagnosed a laceration of the left L3 lumbar artery, immediate transarterial embolization proved life-saving.
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Surg Neurol Int. 2023 Sep 22;14:345. doi: 10.25259/SNI_701_2023. eCollection 2023.ABSTRACTBACKGROUND: Percutaneous pedicle screw (PPS) placement is an established technique for minimally invasive surgery. However, life-threatening hematomas may occur in osteoporotic patients undergoing percutaneous screw placement.CASE DESCRIPTION: An 80-year-old female with an osteoporotic T10 chance fracture developed a life-threatening hematoma following a T8-L3 posterior fusion performed,
Surg Neurol Int. 2023 Sep 22;14:345. doi: 10.25259/SNI_701_2023. eCollection 2023.
ABSTRACT
BACKGROUND: Percutaneous pedicle screw (PPS) placement is an established technique for minimally invasive surgery. However, life-threatening hematomas may occur in osteoporotic patients undergoing percutaneous screw placement.
CASE DESCRIPTION: An 80-year-old female with an osteoporotic T10 chance fracture developed a life-threatening hematoma following a T8-L3 posterior fusion performed with PPS. Prompt angiography diagnosed a life-threatening hematoma attributed to laceration of the left third lumbar artery occurring following pedicle screw (PS) placement into an osteoporotically fractured left L3 transverse process. This was immediately and successfully embolized.
: An 80-year-old female with multiple lumbar osteoporotic fractures developed a life-threatening hematoma during a T8-L3 PS fusion. When the lumbar computed tomography angiography diagnosed a laceration of the left L3 lumbar artery, immediate transarterial embolization proved life-saving.
PMID:37810303 | PMC:PMC10559495 | DOI:10.25259/SNI_701_2023
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Read the original publication:
Retroperitoneal hematoma: A rare complication of percutaneous pedicle screw in an osteoporotic patient