Five consecutive cases of prosthetic inter-vertebral disc displacement with severe vascular complications on revisional surgery
are described. The objective of this case report is to warn spinal surgeons that major vascular complications are likely with
anterior displacement of inter-vertebral discs. We have not been able to find a previous report on vascular complications
associated with anterior displacement of prosthetic inter-vertebral discs. In all five patients the prosthetic disc had eroded
into the bifurcation of the inferior vena cava and the left common iliac vein. In three cases the aortic bifurcation was also
involved. The fibrosis was so severe that dissecting out the arteries and veins to provide access to the relevant disc proved
impossible. Formal division of the left common iliac vein and artery with subsequent repair was our solution. Anterior inter-vertebral
disc displacement was associated with severe vascular injury. Preventing anterior disc displacement is essential in disc design.
In the event of anterior displacement, disc removal should be planned with a Vascular Surgeon.
Keywords Inter-vertebral disc replacement - Artificial inter-vertebral disc - Vascular injury - Disc design - Inter-vertebral arthroplasty