Vascular injury during far lateral disc herniation surgery and its endovascular management: A case report
Muhammet Arif Ozbek1
, Nazli Cakici Oksuz2, Ahmet Tulgar Başak3
1Department of Neurosurgery, İstanbul Medipol University, İstanbul, Türkiye
2Department of Neurosurgery, İstanbul University of Health and Technology, İstanbul, Türkiye
3Department of Neurosurgery, American Hospital, İstanbul, Türkiye
Keywords: Endovascular iliac stent, far lateral disc herniation, vascular injury.
Abstract
Vascular injury is a rare but potentially life-threatening complication of lumbar far lateral microdiscectomy. It requires early diagnosis and effective treatment. We hereby present a case of a 21-year-old male patient admitted to our clinic with complaints of low-back and left leg pain that had not resolved after three months despite medical treatments. Our intervention with far lateral L4-5 microdiscectomy under general anesthesia was intraoperatively complicated by sudden aberrant bleeding. Bleeding was controlled using hemostatic materials. The surgical intervention was discontinued, and an abdominal ultrasonography was performed while the patient was on the operating table. Upon suspicion of retroperitoneal hemorrhage, abdominal computed tomography (CT) and CT angiography were performed while the patient was intubated. The findings indicated the presence of a pseudoaneurysm at the left common iliac artery, which was treated with immediate endovascular stenting. In conclusion, early recognition of such vascular injuries and intervention by taking appropriate decisions after a multidisciplinary approach can prevent mortality and morbidity.
Cite this article as: Ozbek MA, Oksuz NC, Başak AT. Vascular injury during far lateral disc herniation surgery and its endovascular management: A case report. D J Med Sci 2026;12(2):111-116. doi: 10.5606/fng.btd.2026.227.
A.T.B.: Idea/concept, control/supervision; M.A.Ö.: Design, analysis and/or interpretation, references and fundings; M.A.Ö., N.Ç.Ö.: Data collection and/or processing; N.Ç.Ö., A.T.B.: Literature review; M.A.Ö., A.T.B.: Writing the article, materials; A.T.B., N.Ç.Ö.: Critical review.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
Data Sharing Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
The authors received no financial support for the research and/or authorship of this article.
AI Disclosure
The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.