STUDY DESIGN: This article reports a complication encountered when harvesting bone graft from the posterior iliac crest during a contemplated spinal fusion. OBJECTIVES: Posterior iliac crest bone grafting is commonly performed with posterior spinal instrumentation and fusion. SUMMARY OF BACKGROUND DATA: Review of the literature reveals a few case reports of damage through the superior gluteal artery during harvesting of bone grafts; this complication is managed with direct vessel ligation. METHODS: This article reviews the pertinent anatomy of posterior iliac crest bone grafting and addresses areas of caution important in preventing this complication. RESULTS: The case report offers alternative management, that is, selective arterial embolization for hemodynamic control of the massive life-threatening bleeding that can occur with superior gluteal artery lacerations. CONCLUSIONS: Injury to the superior gluteal artery is a common complication in pelvic trauma. In this patient, therapeutic arterial embolization proved to be a useful tool in controlling hemorrhage, which prevents additional bleeding problems. Superior gluteal artery injury after elective bone graft surgery is a relatively uncommon, serious, but avoidable complication. In this patient, the use of radiographically controlled arterial embolization of the lacerated vessel proved to be a quick and effective solution to this potentially life-threatening complication.
STUDY DESIGN: This article reports a complication encountered when harvesting bone graft from the posterior iliac crest during a contemplated spinal fusion. OBJECTIVES: Posterior iliac crest bone grafting is commonly performed with posterior spinal instrumentation and fusion. SUMMARY OF BACKGROUND DATA: Review of the literature reveals a few case reports of damage through the superior gluteal artery during harvesting of bone grafts; this complication is managed with direct vessel ligation. METHODS: This article reviews the pertinent anatomy of posterior iliac crest bone grafting and addresses areas of caution important in preventing this complication. RESULTS: The case report offers alternative management, that is, selective arterial embolization for hemodynamic control of the massive life-threatening bleeding that can occur with superior gluteal artery lacerations. CONCLUSIONS: Injury to the superior gluteal artery is a common complication in pelvic trauma. In this patient, therapeutic arterial embolization proved to be a useful tool in controlling hemorrhage, which prevents additional bleeding problems. Superior gluteal artery injury after elective bone graft surgery is a relatively uncommon, serious, but avoidable complication. In this patient, the use of radiographically controlled arterial embolization of the lacerated vessel proved to be a quick and effective solution to this potentially life-threatening complication.
Authors: David Christopher Kieser; Pierre Coudert; Derek Thomas Cawley; Elodie Gaignard; Takashi Fujishiro; Kaissar Farah; Louis Boissiere; Ibrahim Obeid; Vincent Pointillart; Jean-Marc Vital; Olivier Gille Journal: J Spine Surg Date: 2017-12