RT Journal Article
SR Electronic
T1 Thoracic Aortic Pseudoaneurysm Due to Screw Dislodgment Following Anterior Spinal Approach. Complex Surgical Management of Both Issues: A Case Report and Review of Literature
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 397
OP 402
DO 10.14444/7052
VO 14
IS 3
A1 EGEA-GÁMEZ, ROSA M.
A1 FERREÑO-MÁRQUEZ, DAVID
A1 DE BENITO FERNÁNDEZ, LUIS
A1 LOSADA-VIÑAS, JOSE
A1 GONZÁLEZ-DÍAZ, RAFAEL
YR 2020
UL https://www.ijssurgery.com/content/14/3/397.abstract
AB A few descriptions about anterior thoracic arthrodesis causing thoracic aortic pseudoaneurysms due to late screw loosening are mentioned in the literature. We report a case that describes a hybrid approach complicated with an aortic injury when removing a screw from the aortic wall. A 57-year-old man was initially operated on for scoliosis due to poliomyelitis using dorsal thoracolumbar in situ fusion at an early age. At adulthood, the patient complained of spinal cord compression and severe myelopathy due to D9–D10 nonunion, and the patient required a double surgical approach. Almost a year later, he was diagnosed with a thoracic aneurysm caused by late screw loosening from the anterior plate. A hybrid approach was used to treat the aortic pseudoaneurysm (endograft stent) and for anterior vertebral hardware removal (rethoracotomy). Although an aortic stent was covering the aortic lumen, during the open part of the procedure, an aortic injury took place when removing the screw, requiring quick cross clamping and repair. Anterior vertebral hardware removal after a previous anterior spinal approach is a technically highly demanding procedure. As unexpected life-threatening complications can occur, this procedure should be performed in a setting with the capacity for both endovascular and open aortic repair.