Decker Sebastian, Omar Mohamed, Krettek Christian, Müller Christian W
Sebastian Decker, Mohamed Omar, Christian Krettek, Christian W Müller, Trauma Department, Hannover Medical School, 30625 Hannover, Germany.
World J Clin Cases. 2014 Apr 16;2(4):100-3. doi: 10.12998/wjcc.v2.i4.100.
We present a case of a 33-year-old female who sustained multiple injuries of her spine, including spinous process fractures of C5 to C7 and a lamina fracture of C6 and C7. Her thoracic spine showed transverse process fractures of T4 to T10, a compression fracture and lamina fracture of T3, spinous process and transverse process fractures of T4 and T5, a rotation injury of T6, as well as a compression fracture of L1. Thirteen months after posterior thoracic spinal instrumentation, a pedicle screw was suspected to be in contact with the aorta, which was proved by computed tomography angiograms. Consequently, implant removal was planned with direct exposure of the aorta in order to allow for immediate repair if needed. So far, studies that compare different techniques to remove pedicle screws that are suspected to penetrate the aorta are missing. However, different techniques have been described in case reports, mainly minimally invasive endovascular techniques vs open techniques such as thoracotomy.
我们报告一例33岁女性，其脊柱多处受伤，包括C5至C7棘突骨折以及C6和C7椎板骨折。其胸椎显示T4至T10横突骨折、T3压缩性骨折和椎板骨折、T4和T5棘突及横突骨折、T6旋转损伤以及L1压缩性骨折。在胸椎后路器械植入13个月后，怀疑一枚椎弓根螺钉与主动脉接触，计算机断层血管造影证实了这一点。因此，计划进行植入物取出术，并直接暴露主动脉，以便在需要时立即进行修复。到目前为止，尚缺乏比较不同技术取出疑似穿透主动脉的椎弓根螺钉的研究。然而，病例报告中描述了不同的技术，主要是微创血管内技术与开胸手术等开放技术。
