• Ishwara Keerthi, C S Dhillon, and Mrinal B Shetty.
• Department of Spine Surgery, MIOT Hospitals, Chennai, Tamil Nadu, India. ishkee004@gmail.com
• Spine. 2012 Oct 15;37(22):E1402-5.

Study DesignCase report.ObjectiveTo report a rare complication of anterior spine surgery and instrumentation.Summary Of Background DataAnterior spinal fusion and instrumentation are now frequently used for the treatment of a variety of complex spinal disorders. Several authors have discussed the complications of such procedures. Late perforation of large bowel along with erosion of major vessel after anterior spinal instrumentation is a rare occurrence.MethodsWe present a case of 53-year-old woman who presented with unusual abdominal pain and bleeding of the rectum. She had undergone spine surgery for L5 burst fracture 5 years ago. A detailed evaluation showed perforation of rectosigmoid colon and erosion of left common iliac artery by the anterior spine implants.ResultsThe bowel was repaired and arterial reconstruction was done along with spine implant removal. The patient had complete recovery of symptoms after the treatment.ConclusionDelayed visceral injury with anterior spine surgeries is rare. Early diagnosis is possible with a high degree of suspicion. Meticulous surgical techniques may avoid this complication.

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