Korean J Leg Med.
1999 Oct;23(2):16-26.
Vascular injuries associated with lumbar disk surgery: medicolegal implications
- Affiliations
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- 1Department of Forensic Medicine, National Institute of Scientific Investigation, Korea.
Abstract
- Symptomatic perforation of the anterior annulus fibrosus/anterior longitudinal ligament during surgery for herniated lumbar disc disease is one of the more solemn and sobering complications experienced by neurosurgeons or orthopedic surgeons. Iatrogenic vascular injuries are unusual complications of lumbar disk surgery. The incidence of such injuries is very low but probably underestimated because clinical manifestations may be extremely variable depending on the extension of trauma. Diagnosis is suspected when early signs or retroperitoneal hemorrhage appear, but may often be delayed. I experienced 5 autopsied cases of acute hemorrhage due to vascular trauma in disk surgery. A review of the literature is present and the medicolegal implications of symptomatic ventral perforations of the annulus fibrosus/anterior longitudinal ligament are discussed.
