A 31-year-old woman presented with persistent left leg pain 3 weeks after revision lumbar surgery. She had numbness of the leg immediately after surgery, followed by intense, spasmodic pain 4 days later, which was managed with analgesia. Subsequent computed tomographic angiography demonstrated occlusion of the left common iliac artery. This had been missed by her spinal surgeon and by physicians in our emergency department in 2 separate visits. Vascular complications of anterior spinal surgery can be limb- or life-threatening. A high index of suspicion is necessary.
