Retroperitoneal hematoma: A rare complication of percutaneous pedicle screw in an osteoporotic patient

BACKGROUND: Percutaneous pedicle screw (PPS) placement is an established technique for minimally invasive surgery. However, life-threatening hematomas may occur in osteoporotic patients undergoing percutaneous screw placement. CASE DESCRIPTION: An 80-year-old female with an osteoporotic T10 chance fracture developed a life-threatening hematoma following a T8–L3 posterior fusion performed with PPS. Prompt angiography diagnosed a life-threatening hematoma attributed to laceration of the left third lumbar artery occurring following pedicle screw (PS) placement into an osteoporotically fractured left L3 transverse process. This was immediately and successfully embolized. CONCLUSION: An 80-year-old female with multiple lumbar osteoporotic fractures developed a life-threatening hematoma during a T8–L3 PS fusion. When the lumbar computed tomography angiography diagnosed a laceration of the left L3 lumbar artery, immediate transarterial embolization proved life-saving.