Freyrie Antonio, Gasbarrini Alessandro, Simoes Christiano Esteves, Gallitto Enrico, Gargiulo Mauro
Vascular Surgery, Bologna University, S. Orsola Malpighi Policlinic, Bologna, Italy.
Ann Vasc Surg. 2013 May;27(4):499.e1-3. doi: 10.1016/j.avsg.2012.07.025. Epub 2013 Mar 29.
Iatrogenic aortic injuries by pedicle screws are rare but serious complications of spinal fixation surgery. We report the case of a 55-year-old man who underwent surgical correction of traumatic thoracic vertebral fractures at another institution. At 6-month follow-up, computed tomography revealed a nonhealing of the fractures, and a T4 misplaced pedicle screw penetrating the descending thoracic aorta. The patient underwent open aortic repair associated with the anterior vertebral column reconstruction and posterior arthrodesis revision by a vascular and orthopedic surgery team simultaneously.
椎弓根螺钉导致的医源性主动脉损伤虽罕见,但却是脊柱固定手术的严重并发症。我们报告一例55岁男性病例,该患者在另一机构接受了创伤性胸椎骨折的手术矫正。在6个月的随访中,计算机断层扫描显示骨折未愈合,且一枚T4椎弓根螺钉位置不当,穿透了降主动脉。该患者接受了开放性主动脉修复手术,同时由血管外科和骨科手术团队进行了前路脊柱重建和后路关节融合翻修手术。