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Case Report
Korean J Spine 2006;3(1): 52-56.
8
Aortic Wall Injury which Developed During Debridement of Spondylitis Following Vertebroplasty - Case Report -
Jae-Hyun Lee, M.D., Hyung-Jun Kwak, M.D., Jung-Kil Lee, M.D., Kyung-Sub Moon, M.D., Sung-Pil Joo, M.D., Jae-Hyoo Kim, M.D., Soo-Han Kim, M.D., Won-Chae Chang, M.D.
Department of Neurosurgery and Cardiovascular and Thoracic Surgery*, Chonnam National University Hospital, Gwangju, Korea
Aortic Wall Injury which Developed During Debridement of Spondylitis Following Vertebroplasty - Case Report -
Jae-Hyun Lee, M.D., Hyung-Jun Kwak, M.D., Jung-Kil Lee, M.D., Kyung-Sub Moon, M.D., Sung-Pil Joo, M.D., Jae-Hyoo Kim, M.D., Soo-Han Kim, M.D., Won-Chae Chang, M.D.
Abstract
Percutaneous vertebroplasty is a commonly used procedure in the treatment of painful vertebral fractures induced by osteo- porosis and metastatic disease. It is generally considered to be safe and effective. However, infectious complications are quite severe. We present a patient in whom pyogenic spondylitis developed 3 months after vertebroplasty. During the debridement, profuse bleeding was encountered from the injured aorta and the patient was managed with primary closure. Two months after the initial surgery, an aortic aneurysm was detected. A wide resection of all infected tissue, including the bony lesion and aortic aneurysm was performed, and the descending thoracic aorta was replaced with Hemoshield vascular graft. A titanium mesh cage filled with bone graft was employed for anterior reconstruction. Our case illustrates that a life-threatening aortic aneurysm can indeed occur as an infectious complication of this minimally invasive procedure due to the proximity of the aorta to the thoracolumbar vertebra. The spine surgeon should be aware of the possibility of aortic wall erosion caused by long-standing spondylitis, and be prepared to manage an inadvertent injury to the aorta during the surgical debridement.
Keywords: Aortic aneurysm․Complication․Spondylitis․Vertebroplasty
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