Introduction:

currently, posterior instrumented lumbar fusion is very frequently used. One of its complications is the poor position of the pedicle screws.

Case report:

a 57-year-old male presented significant bleeding after introducing a lumbar pedicle screw during surgery for lumbar canal stenosis. The wrong position of the screw caused intraoperative hemodynamic instability due to injury to the lumbar segmental artery, causing hematoma of the psoas muscle, in addition to neurological symptoms of related peripheral nerves, reaching the diagnosis by computed tomography, with the resolution by conservative treatment.

Conclusion:

surgery for low back pain and fixation with pedicle screws is a frequent, effective, and safe procedure; however, in case of uncontrollable bleeding when the screws are inserted, vascular damage must be considered.