Abstract
A 74-year-old man developed a severe low back pain and a fever. In the initial examinations, a collapse of the L5 anterosuperior vertebral body and narrowing of the L4/5 disc space were identified on radiographs, and the laboratory data showed inflammatory results. A computed tomography (CT) and a magnetic resonance imaging showed collapse of L5. A needle biopsy was performed to make a diagnosis; however, an abdominal pain and a hypotension appeared after the biopsy. An abdominal CT showed a hematoma in the retroperitoneal space, and an angiography revealed a left fourth lumbar artery pseudoaneurysm. The pseudoaneurysm was treated with transcatheter placement of microcoils. Although haemorrhagic complications following needle biopsy are very rare, patients with large amounts of vertebral destruction may have unusual anatomical positions of the lumber artery. Therefore, surgeons should be aware of the possibility of lumbar artery injury during a needle biopsy and take care of prebiopsy plans.
Highlights
Percutaneous needle biopsy of vertebral bodies through posterior approach, relatively simple and safe technique with low complication rate, is widely used in cases of suspected spondylitis or tumor metastasis of spine [1]
An abdominal computed tomography (CT) showed a hematoma in the retroperitoneal space, and an angiography revealed a left fourth lumbar artery pseudoaneurysm
We describe an unusual case of 74-year-old man who developed pseudoaneurysm of fourth lumbar artery following vertebral body needle biopsy
Summary
Percutaneous needle biopsy of vertebral bodies through posterior approach, relatively simple and safe technique with low complication rate, is widely used in cases of suspected spondylitis or tumor metastasis of spine [1]. Some problems remain with such needle biopsies, one of which is neural or vascular damage. Haemorrhagic complication of lumbar arteries following needle biopsy is uncommon, and only few cases have been reported [2, 3]. We describe an unusual case of 74-year-old man who developed pseudoaneurysm of fourth lumbar artery following vertebral body needle biopsy
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