The use of polymethyl methacrylate as an effective tamponade for a vertebral artery injury during anterior cervical corpectomy and fusion: A case report

Introduction: Injury to the vertebral artery (VA) during an anterior cervical approach to the spine is relatively uncommon. These injuries can be difficult to repair, may lead to significant complications, and can even be fatal. We present a case report involving a VA injury that occurred during an anterior cervical corpectomy and fusion and discuss its management. Case Report: A 65-year-old man presented with a chief complaint of radicular left upper extremity pain without weakness, numbness, or paresthesia. Imaging revealed cervical spondylosis with a kyphotic deformity. An anterior cervical corpectomy and fusion was recommended and the patient agreed to proceed with the surgery. During the drilling of the vertebral body, the left lateral wall of the vertebral body was inadvertently perforated, resulting in an injury to the VA. To address this complication polymethyl methacrylate (PMMA) was placed in the defect to replace the vertebral body and provide effective tamponade against the bleed. Conclusion: Polymethylmethacrylate can be a very effective tool to use in the management of an injury to the VA, providing the ability to tamponade while simultaneously helping to maintain structural integrity and spinal stability.