External iliac artery occlusion in posterior spinal surgery

Study Design. Report of a case of external iliac artery occlusion occurring as a rare complication of lumbar posterior spinal surgery. Objective, To clarify the cause of this rare complication and recommend methods for preventing its recurrence, Summary of Background Data. Several cases of central retinal artery occlusion after posterior spinal surgery have been reported, but there has been no reported case of external iliac artery occlusion after posterior spinal surgery. Methods. A 65-year-old woman who had a 32-year history of systemic lupus erythematosus underwent posterior decompression and spinal fusion for degenerative scoliosis. Site was supported on a Hall frame during the operation. Three hours after surgery, paralysis and sensory impairment of the left leg acid cyanosis of the toes of the left foot were noted. The popliteal, dorsalis pedis, and posterior tibial pulses were not palpable. Angiography showed complete occlusion of the external iliac artery, end emergency removal of the thrombus was performed. Results. One year later, neurologic symptoms were absent, and the leg vessels were normal. Conclusions. Prolonged direct pressure on the inguinal region during posterior spinal surgery on a Hall frame may cause external iliac artery occlusion. Early recognition and adequate treatment can prevent serious sequelae.