Presentation and management of IVC and iliac vein encroachment by lumbar pedicle screws: A case-report

Abstract

Pedicle screws are commonly used in spinal surgeries and are relatively safe, with venous complications occurring rarely.We report a patient with imaging following a L4-5 fusion that showed indentation of the inferior vena cava and right common iliac vein by the right L4 and L5 pedicle screws. She underwent revision surgery in which the hardware was removed and no bleeding was observed. Intraoperative venogram confirmed vascular integrity and absence of indentation on the venous structures following screw removal. The patient recovered without complications. Venous contact by pedicle screws should be treated on a case-by-case basis in a multidisciplinary approach with vascular surgery. We discuss a treatment algorithm for the operative management of this problem.