Vertebral artery injury during anterior decompression of the cervical spine

Objective To evaluate the risk factor and treatment method of the vertebral artery injury during anterior decompression of the cervical spine. Methods Seven hundred and twenty patients undergone anterior cervical operation from January 1980 to December 1998 were reviewed. The range of decompression included one level, two levels, three levels and subtotal vertebral body resection. Speed burr was used to resect the bone and disc. Caspar plate was implanted in 630 cases after decompression. Three cases suffered iatrogenic vertebral artery injury when removal of bone and disc was excessive laterally. Emergent control of haemorrhage was achieved by local tamponade using hemostatic agent and free muscle slice. Results Vertebral artery injury occurred in 0.4％ of this series. The control of haemorrhage had been successful by tamponade in all of the three cases. None had ischemic complications. Conclusion Decompress laterally from the uncovertebral joint should not be attempted. Local tamponade using hemostatic agent and free muscle slice was effective to control vertebral artery bleeding.