The Journal of Spinal Surgery

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VOLUME 6 , ISSUE 2 ( April-June, 2019 ) > List of Articles

CASE REPORT

Management of Endovascular Intervention Complication in Spinal Vascular Malformation—Report of Two Cases

Manish Beniwal, Indiradevi Bhagavatula, Amit Padwal

Keywords : Complication, Intervention, Laminectomy, NBCA, Onyx

Citation Information : Beniwal M, Bhagavatula I, Padwal A. Management of Endovascular Intervention Complication in Spinal Vascular Malformation—Report of Two Cases. J Spinal Surg 2019; 6 (2):65-68.

DOI: 10.5005/jp-journals-10039-1210

License: CC BY-NC 4.0

Published Online: 01-09-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Aim: Management of cases of spinal vascular malformation, complicated by vessel injury during catheterization. Background: Vascular abnormalities of the spinal cord are rare group of spinal cord disease and complex angioarchitecture of these lesions makes its treatment both by surgical or radiological intervention technically demanding. Case description: We report two cases of spinal vascular malformation, complicated by vessel injury during catheterization. In case 1, extravasation of embolic material and blood could be documented by the digital subtraction angiogram (DSA), the patient developed progressive sensorimotor deficits after the next 48 hours, whereas in case 2, the patient developed immediate postprocedural weakness in both lower limbs and postprocedural computed tomography (CT) showed glue material in the spinal canal. Both the patients underwent decompressive laminectomy and showed improvement in motor power. Conclusion: Following intervention, if the patient develops weakness, it is generally thought to be due to ischemia, and not due to extravasated material (glue + hematoma). When imaging shows the mass effect due to this complication, the patient should undergo decompression instead of taking a pessimistic attitude of not doing anything due to supposedly arterial ischemia and infarct.


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