Death Following Direct Lateral Sacroiliac Joint Fusion Surgery Due To Iliac Artery Injury: A Case Report

Case Summary

This report details the case of a 40-year-old Caucasian male who suffered from chronic low back pain due to a disruption in the right sacroiliac (SI) joint. The individual underwent a minimally invasive procedure known as sacroiliac joint arthrodesis, utilizing the SI-Bone direct lateral iFuse Triangular Titanium Implant (TTI) wedges SI joint fusion system using Steinmann pins and a cannulated drill .

During the surgery, significant bleeding (200 ml) was observed following the withdrawal of a drill. Despite this, the surgery continued and the patient postoperatively initially seemed to recover, remaining conscious, alert, and cooperative for 4 hours post-surgery, although he reported experiencing severe abdominal pain. Notably, a mild tachycardia was detected but not further examined, and hemoglobin levels were not monitored.

To manage the pain, the patient was administered morphine through a pump. Two hours thereafter, he was discovered unconscious. Despite efforts to resuscitate him manually, these attempts were unsuccessful. Subsequent postmortem analysis revealed the cause of bleeding as a perforation in a branch of the right internal iliac artery, ultimately leading to the patient's death postoperatively.