The case with which this complication can occur can only be appreciated by the surgeon in whose hands such an unfortunate incident has happened. The gravity of the complication would indicate that prevention would be the best cure, but it must be emphasized again that the accident reported here happened while the surgeon was attempting to avoid just such a complication.
Four other known but unpublished instances of similar vascular damage, each with grave result, are known to have occurred. The fatal outcome in the majority of these cases places this complication among the dire surgical emergencies. Upon the slightest suspicion of vascular injury, large amounts of whole blood should be made available at the earliest possible moment. Decision in the diagnosis and treatment may be difficult. In any instance where the patient's circulatory condition shows marked change, however, there would seem real indication to attempt immediate repair of the vascular injury. Because of the potential danger to a patient undergoing disc surgery, it would seem advisable to determine routinely before operation the blood type and the Rh factor.