Iatrogenic Common Iliac Vessel Injury During Routine Degenerative Lumbar Spine Surgery: Report of 2 Cases and Review of Literature

Injury of the iliac vessels is a rare complication of lumbar spine surgery with potentially life-threatening consequences. We present 2 cases of iliac vessel injury that were treated with minimally invasive techniques. The first case was a laceration of the common iliac artery during a simple L4-L5 discectomy in which the injured artery was secured by stent implantation. The second case was an example of injury to the left iliac common vessel leading to acute lower limb ischemia and arteriovenous fistula formation after lumbar spinal canal stenosis surgery. The patient was treated in 2 steps. First, a temporary femorofemoral bypass was implanted to revascularize the right lower limb. The second step involved stent implantation in the right common iliac artery to close the arteriovenous fistula. Both patients were treated without extensive laparotomy and had good clinical outcomes. This case series emphasizes the benefit of quick minimally invasive vascular repair available in multidisciplinary centers.