Segmental artery injury

3D Reconstructions of
Spinal Segmental Arteries
using CT Angiography
: Applications in Spinal Surgery
Dong Hwa Heo, MD., PhD.
Spine Center, Dept of Neurosurgery
Hallym University Medical Center,
South Korea

Segmental artery injury

Segmental artery
Minimal Invasive Approach Segmental artery injury
Retroperitoneal hematoma
Minimal Invasive Approach
• Endoscopic discectomy

What can we do for prevention of
“Segmental artery injury”
What can we do for prevention of
“Postop. Retroperitoneal hematoma”
Minimally invasive approach

• 3D reconstruction
Materials and Methods
Segmental arteries images
with vertebral bodies

Results
• Segmental artery pathway zone (%)

Significantly higher frequency of segmental arteries with uncommon
pathways at L2 through L4
Potential Risk of segmental artery injury during lumbar MISS

Clinical application of Spinal CTA
65/M
L4-5 extraforaminal disc herniation Lt
Paramedian approach or Endoscopic approach
Choice Open Paramedian approach

Anatomical variations of Segmental arteries
1. Dual supply
2. Agenesis or Obliteration

Conclusion
• Spinal CTA can help to precisely visualize the spinal
segmental arteries and surrounded bony structures
• Help in planning spinal surgeries
Practical applications – Preoperative evaluation
Vertebroplasty, Osteoplasty
Endoscopic discectomy
Retroperitoneal approach
Paramedian approach
Conflict of interest: None