Postdiskectomy AV fistula: CT angiographic demonstration

Postdiskectomy vascular complications are well known. Immediate postoperative vascular complications are diagnosed promptly and treated successfully in most cases. Postdiskectomy arteriovenous fistula occurs due to perforation of the anterior longitudinal ligament with injury to adjacent vessels like aorta, iliac vein, iliac artery or inferior vena cava, iliac vein being the most commonly involved vascular structure. In most patients, overt signs and symptoms of postdiskectomy fistula are not apparent until many years after injury usually presenting as high output failure. Although catheter angiography has been the gold standard for diagnosis, CT angiography with 64 slice CT gives’ spectacular’ 3 dimensional and multiplanar demonstration of the fistula, making direct angiography unnecessary.