Harms technique of CI-C2 fixation for atlantoaxial complex becomes more popular due to good fusion rate and low vertebral artery injury （VAI） rate. But considering the unique and variable anatomy of atlanto- axial c...Harms technique of CI-C2 fixation for atlantoaxial complex becomes more popular due to good fusion rate and low vertebral artery injury （VAI） rate. But considering the unique and variable anatomy of atlanto- axial complex, iatrogenic VAI will result in catastrophic con- sequences and provides particular surgical challenges for surgeons. To our knowledge, comparing with iatrogenic VAI in the screw hole, iatrogenic VAI in the ＂open space＂ is much rarer during the Harms technique of C1-C2 fixation. In this article, we present a case of iatrogenic vertebral artery pseudoaneurysm after Harms technique of posterior C1-C2 fixation. This case of iatrogenic VAI effectively treated by endovascular coil occlusion and external local compressionwas initially misdiagnosed as VAI by pedicle screw perforation. It can be concluded that intraoperative or post- operative computed angiography is very helpful to diag- nose the exact site of VAI and the combination of endovascular coil occlusion as well as external local com- pression can further prevent bleeding and abnormal verte- bral artery flow in the pseudoaneurysm. However, patients treated require further follow-up to confirm that there is no recurrence of the Dseudoaneurysm.展开更多
文摘Harms technique of CI-C2 fixation for atlantoaxial complex becomes more popular due to good fusion rate and low vertebral artery injury （VAI） rate. But considering the unique and variable anatomy of atlanto- axial complex, iatrogenic VAI will result in catastrophic con- sequences and provides particular surgical challenges for surgeons. To our knowledge, comparing with iatrogenic VAI in the screw hole, iatrogenic VAI in the ＂open space＂ is much rarer during the Harms technique of C1-C2 fixation. In this article, we present a case of iatrogenic vertebral artery pseudoaneurysm after Harms technique of posterior C1-C2 fixation. This case of iatrogenic VAI effectively treated by endovascular coil occlusion and external local compressionwas initially misdiagnosed as VAI by pedicle screw perforation. It can be concluded that intraoperative or post- operative computed angiography is very helpful to diag- nose the exact site of VAI and the combination of endovascular coil occlusion as well as external local com- pression can further prevent bleeding and abnormal verte- bral artery flow in the pseudoaneurysm. However, patients treated require further follow-up to confirm that there is no recurrence of the Dseudoaneurysm.
