• Peter Hanks Maughan, Andrew F Ducruet, Ali M Elhadi, Nikolay L Martirosyan, Mark Garrett, Raza Mushtaq, Felipe C Albuquerque, and Nicholas Theodore.
• Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
• Neurosurgery. 2013 Dec 1; 73 (2 Suppl Operative): ons271-81; discussion ons281-2.

BackgroundIatrogenic vertebral artery (VA) injury is a rare but potentially devastating complication associated with cervical and craniocervical surgery.ObjectiveTo retrospectively evaluate treatment modalities and outcomes associated with iatrogenic VA injury.MethodsOur institutional surgical database was queried for patients who underwent cervical or craniocervical surgery from January 1997 to August 2012.ResultsDuring this time period, 8213 patients underwent cervical or craniocervical surgery, and 17 (0.2%) cases of VA injury were identified. Eight (47%) of these injuries occurred during C1-2 instrumentation procedures. Primary microsurgical repair of the VA was performed in 5 patients. Other cases were managed by either surgical or endovascular VA occlusion. Of the 17 patients, 15 underwent immediate angiography, 9 of whom were ultimately treated by the use of endovascular techniques.ConclusionVA injury is an uncommon complication of cervical and/or skull base surgery. Standardized management recommendations may help reduce complications associated with these rare but potentially devastating injuries.

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