Somatosensory-Evoked Potential Monitoring Detects Iliac Artery Occlusion During Posterior Spinal Fusion

In Brief Study Design. Report of a rare case of iliac artery occlusion occurring during posterior spinal surgery. Objective. To clarify causes of an acute occlusion of iliac vessels during posterior spinal surgery. Summary of Background Data. Acute embolic occlusion of the iliac artery is a medical and surgical emergency. Iatrogenic occlusion of major vessels to the lower extremities during posterior lumbar spine operation is a rare entity. Methods. We report this complication occurring during decompression and fusion in a 55-year-old female with history of diabetes, hyperlipidemia, and multivessels vascular disease. The application of somatosensory evoked potentials during this case detected an asymmetry of cortical responses due to low blood flow to the affected limb. Results. This patient underwent endovascular intervention and placement of stents to restore the flow to the limbs. Conclusion. It is feasible to assume that continuous and direct pressure on the inguinal region during surgery on Jackson table was the primary cause of the iliac artery occlusion, particularly in these patients with known peripheral vascular disease. Early recognition and prompt vascular intervention can prevent serious sequelae. This is a report of a rare case of iliac artery occlusion occurring during posterior spinal surgery. This complication occurred during decompression and fusion in a 55-year-old female with history of diabetes, hyperlipidemia, and multivessels vascular disease. The application of somatosensory evoked potentials during this case detected an asymmetry of cortical responses due to low blood flow to the affected limb. It was assumed that the direct pressure on the inguinal region during surgery on Jackson table was the primary cause of the iliac artery occlusion, particularly in these patients with known peripheral vascular disease.