Emergency diagnosis with spiral CT angiography in case of suspected ventral perforation following lumbar disc surgery

• Published in: Surgical neurology Vol. 57; no. 1; pp. 15 - 18
• Main Authors: Lange, Manfred, Fink, Ulrich, Philipp, Andreas, Oeckler, Reinhard
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2002
• Subjects: Adult; Angiography - methods; emergency diagnostic; Emergency Medical Services; Female; Humans; Intervertebral Disc Displacement - surgery; Intraoperative Complications; laparotomy; Lumbar disc surgery; Lumbar Vertebrae - blood supply; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Microsurgery; Middle Aged; Rupture - diagnostic imaging; Rupture - etiology; spiral CT angiography; Tomography, X-Ray Computed - methods; vascular lesion; ventral perforation; Vertebral Artery - diagnostic imaging; Vertebral Artery - surgery; ventral perforation; Lumbar disc surgery; vascular lesion; emergency diagnostic; laparotomy; spiral CT angiography
• ISSN: 0090-3019; 1879-3339
• DOI: 10.1016/S0090-3019(01)00672-3

BACKGROUND
Ventral perforation and vascular lesions are rare but life-threatening complications in lumbar disc surgery. In some cases, however, it remains unclear from the clinical situation whether a laparotomy is necessary to save the patient. The goal of this study is to demonstrate the value of spiral CT (computed tomography) angiography for emergency vascular diagnosis in two cases.
METHODS
Spiral CT angiography with an intravenous bolus contrast medium injection and reconstruction with images in sagittal, coronal, and oblique planes was performed.
RESULTS
Spiral CT angiography confirms or excludes a vascular lesion, as demonstrated in two case reports.
CONCLUSION
In unclear cases when ventral perforation in lumbar disc surgery is suspected, the need for emergency laparotomy can be confirmed quickly by noninvasive spiral CT angiography.