Vascular complications of prosthetic inter-vertebral discs

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From www.pubmedcentral.com. Eur Spine J. 2006 October; 15(Suppl 17): 644–649.

Vascular complications of prosthetic inter-vertebral discs
Kevin J. Daly,1 E. RaymondS. Ross,2 Heather Norris,2 and Charles N. McCollum1
1Department of Surgery, South Manchester University Hospital, Manchester, UK
2Department of Orthopaedic Surgery, Hope Hospital, Salford, UK

Abstract
Five consecutive cases of prosthetic inter-vertebral disc displacement with severe vascular complications on revisional surgery are described. The objective of this case report is to warn spinal surgeons that major vascular complications are likely with anterior displacement of inter-vertebral discs. We have not been able to find a previous report on vascular complications associated with anterior displacement of prosthetic inter-vertebral discs. In all five patients the prosthetic disc had eroded into the bifurcation of the inferior vena cava and the left common iliac vein. In three cases the aortic bifurcation was also involved. The fibrosis was so severe that dissecting out the arteries and veins to provide access to the relevant disc proved impossible. Formal division of the left common iliac vein and artery with subsequent repair was our solution. Anterior inter-vertebral disc displacement was associated with severe vascular injury. Preventing anterior disc displacement is essential in disc design. In the event of anterior displacement, disc removal should be planned with a Vascular Surgeon.

Keywords: Inter-vertebral disc replacement, Artificial inter-vertebral disc, Vascular injury, Disc design, Inter-vertebral arthroplasty

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