Department of Orthopedics and Traumatology, Medical University of Silesia, Katowice, Poland.
Spine (Phila Pa 1976). 2012 Oct 15;37(22):E1406-9. doi: 10.1097/BRS.0b013e3182685a36.
A rare case of direct injury to the wall of abdominal aorta caused by a displaced fracture of the L2 vertebral body resulting from a low-energy injury. Potential injury mechanism and predisposing factors are discussed along with a review of literature pertaining to the subject.
To describe a unique case of direct aortic wall injury caused by a displaced vertebral body fracture.
The literature on aortic wall injuries after vertebral fractures is reviewed. So far, only the injuries of the thoracic aorta were extensively described. Injuries of the abdominal aorta are much less frequent and usually associated with high-energy trauma. However, coexisting disorders, predisposing the patient to thoracolumbar vertebral body fractures (e.g., osteoporosis, chronic alcoholism) and aortic wall injuries (atherosclerosis) make aforementioned complication possible, despite the low-energy mechanism of injury.
A clinical and radiographical interpretation of the reported case is presented.
Laceration of abdominal aorta was caused by a sharp, anteriorly displaced bone fragment of the fractured L2 vertebral body.
The reported case adds to the literature on vertebral fractures by describing another mechanism leading to aortic wall disruption. Similar vascular complications may be identified more frequently in the future given the high prevalence of osteoporosis and atherosclerosis in the general population.
罕见的由 L2 椎体移位性骨折导致的腹壁主动脉壁直接损伤,该骨折由低能量损伤引起。讨论了潜在的损伤机制和易患因素,并对相关文献进行了回顾。
描述由移位性椎体骨折引起的独特的主动脉壁直接损伤病例。
对主动脉壁损伤后发生的椎体骨折的文献进行了回顾。到目前为止,仅广泛描述了胸主动脉的损伤。腹主动脉的损伤则更为少见,且通常与高能创伤相关。然而,一些共存的疾病使患者易患胸腰椎体骨折(如骨质疏松症、慢性酒精中毒)和主动脉壁损伤(动脉粥样硬化),即使损伤机制为低能量,上述并发症仍有可能发生。
对报告的病例进行临床和影像学解读。
破裂的 L2 椎体的尖锐、向前移位的骨片导致了腹主动脉的撕裂。
该报告病例通过描述另一种导致主动脉壁破裂的机制,为椎体骨折的文献增添了新内容。鉴于骨质疏松症和动脉粥样硬化在普通人群中的高发病率,未来可能会更频繁地发现类似的血管并发症。