• Runqi Wangqin, Kaya Xu, Maxim Mokin, Juan Uribe, Haydy Rojas, and Zeguang Ren.
• Department of Neurology, Duke University Medical Center, Durham, North Carolina, USA.
• World Neurosurg. 2019 Feb 1; 122: 282-286.

BackgroundIatrogenic vertebral artery injury is an uncommon but well recognized complication during cervical spine surgery. Intraoperative surgical repair is extremely challenging, and options for endovascular repair are limited because of the lack of proper equipment in the operating room setting.Case DescriptionA 53-year-old woman who presented with myelopathy underwent anterior cervical diskectomy and fusion of C3-7. A significant laceration injury of the left vertebral artery was encountered during surgery, which was salvaged by intraoperative endovascular repair with a covered stent under portable fluoroscopy guidance. The salvage and repair led to the rest of the surgery being finished as planned preoperatively without any consequences.ConclusionsVertebral artery injury is an uncommon but severe complication of cervical spine surgery. For uncontrolled bleeding, intraoperative endovascular repair with portable fluoroscopy is warranted and possible. A covered stent can seal the laceration and stop the bleeding completely which enables completion of the surgery.Copyright © 2018 Elsevier Inc. All rights reserved.

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