Profound Hypotension in L2 Burst Fracture Patient Associated with Superior Gluteal Artery Rupture

Rupture of the superior gluteal artery (SGA) is a rare complication. The SGA is vulnerable to injury during pelvic trauma due to its position in the sciatic notch. We report an unusual case of a successfully embolized SGA rupture in L2 burst fracture patient with blunt buttock contusion without associated pelvic fracture. A 45-year-old male was presented to the emergency room (ER) with L2 burst fracture showing a hypovolemic shock state. A computed tomography (CT) scan of the abdomen and pelvis revealed diffuse swelling of the right gluteus muscles with highly attenuated massive hematoma. Emergency pelvic angiography revealed a rupture of the right SGA. Sequential embolization was performed successfully. The patient underwent decompressive L2 total laminectomy with posterior fusion after stabilization of vital sign. The patient became neurologically improved after the operation. Although SGA injury is rare in L2 burst fracture associated with blunt trauma to the pelvis, the presence of hypotensive shock with clinical symptoms warrants the investigation of these vascular injuries. Selective angiography and embolization is considered the treatment of choice.