STUDY DESIGN: Case report. OBJECTIVE: We present a rare complication of iliac artery perforation during lumbar disc surgery using a microscope-attached carbon dioxide laser system. SUMMARY OF BACKGROUND DATA: Since 1991, the authors have used a carbon dioxide laser to ablate disc fragment and osteophyte during lumbar microdiscectomy as a safe and convenient alternative to the scalpel and rongeur. We report the first case of a major vascular injury due to carbon dioxide laser. METHODS: A 42-year-old female patient underwent a right L5-S1 microdiscectomy for paramedian disc herniation. During the discectomy, the carbon dioxide laser was operated in continuous mode and irradiated anteriorly to ablate the intervertebral disc. High-energy (20 W) laser radiation caused perforation of a major vessel. RESULTS: Emergent laparotomy was performed, and a right iliac artery injury was discovered and successfully repaired by general and vascular surgeons. The patient was discharged home without sequelae after 10 days. CONCLUSION: Lasers are used in many different medical fields and offer unique advantages. However, the physical capabilities of a laser should be fully recognized to avoid complication. In this case, prompt diagnosis and emergent laparotomy salvaged the laser-induced arterial injury.
STUDY DESIGN: Case report. OBJECTIVE: We present a rare complication of iliac artery perforation during lumbar disc surgery using a microscope-attached carbon dioxide laser system. SUMMARY OF BACKGROUND DATA: Since 1991, the authors have used a carbon dioxide laser to ablate disc fragment and osteophyte during lumbar microdiscectomy as a safe and convenient alternative to the scalpel and rongeur. We report the first case of a major vascular injury due to carbon dioxide laser. METHODS: A 42-year-old female patient underwent a right L5-S1 microdiscectomy for paramedian disc herniation. During the discectomy, the carbon dioxide laser was operated in continuous mode and irradiated anteriorly to ablate the intervertebral disc. High-energy (20 W) laser radiation caused perforation of a major vessel. RESULTS: Emergent laparotomy was performed, and a right iliac artery injury was discovered and successfully repaired by general and vascular surgeons. The patient was discharged home without sequelae after 10 days. CONCLUSION: Lasers are used in many different medical fields and offer unique advantages. However, the physical capabilities of a laser should be fully recognized to avoid complication. In this case, prompt diagnosis and emergent laparotomy salvaged the laser-induced arterial injury.