Minor Michael E, Morrissey Nicholas J, Peress Richard, Carroccio Alfio, Ellozy Sharif, Agarwal Gautam, Teodorescu Victoria, Hollier Larry H, Marin Michael L
Department of Surgery, Division of Vascular Surgery, The Mount Sinai School of Medicine, New York, NY 10029, USA.
J Vasc Surg. 2004 Apr;39(4):893-6. doi: 10.1016/j.jvs.2003.10.056.
Iatrogenic aortic injuries after spinal surgery have been described, but are rare. We describe a case of a 77-year-old woman who underwent surgical correction of a debilitating spinal deformity at an outside institution. Postoperative thoracic spine radiographs and computed tomography scans revealed a misplaced pedicle screw at T5, which was impinging on the descending thoracic aortic wall. The patient was brought to the operating room, where a thoracic stent graft was deployed under fluoroscopic guidance as the malpositioned screw was manually retracted. The patient had an uneventful postoperative course, and was discharged within 24 hours. This case represents a rare but potentially morbid vascular complication of spinal instrumentation surgery that was successfully treated without the need for thoracotomy.
脊柱手术后医源性主动脉损伤已有报道，但较为罕见。我们描述了一例77岁女性患者，她在外部机构接受了严重脊柱畸形的手术矫正。术后胸椎X线片和计算机断层扫描显示T5椎弓根螺钉位置不当，压迫胸降主动脉壁。患者被送往手术室，在透视引导下置入胸主动脉覆膜支架，同时手动回撤位置不当的螺钉。患者术后恢复顺利，24小时内出院。该病例代表了脊柱内固定手术一种罕见但可能致命的血管并发症，无需开胸手术即成功治疗。
