Delayed aortic rupture caused by an implanted anterior spinal device - Case report

Citation
T. Ohnishi et al., Delayed aortic rupture caused by an implanted anterior spinal device - Case report, J NEUROSURG, 95(2), 2001, pp. 253-256
Citations number
7
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Neurology,"Neurosciences & Behavoir
Journal title
JOURNAL OF NEUROSURGERY
ISSN journal
0022-3085 → ACNP
Volume
95
Issue
2
Year of publication
2001
Supplement
S
Pages
253 - 256
Database
ISI
SICI code
0022-3085(200110)95:2<253:DARCBA>2.0.ZU;2-Y
Abstract
The authors describe a case of delayed aortic rupture following the applica tion of a smooth-rod Kaneda (SRK) instrument. This is a rare but critical c omplication of anterior spinal fusion in which instrumentation is placed, a nd the authors wish to draw attention to the possible complications arising from such surgery. A few cases of this complication were reported in 1986. No reports have been published since then; perhaps because techniques and implant design have improved. In this case, a 53-year-old man suffered a T- 11 fracture and related paraparesis, and he underwent decompression and ant erior fusion in which an iliac bone graft was placed using an SRK device. A lthough his neurological deficit resolved postoperatively, nonunion of the grafted bone caused progressive kyphosis of the thoracolumbar spine. Twenty months after surgery, he complained of progressive gastrointestinal sympto ms, and a delayed aortic rupture with a pseudoaneurysm. was found surroundi ng the implant. The aortic pseudoaneurysm was replaced with an artificial v essel, and the SRK device was removed immediately. Delayed aortic rupture a ssociated with anterior instrumentation is extremely rare but can occur. Ev en if the design of the implants can be improved, the placement of implants near the aorta and subsequent changes in the close anatomical relationship between the aorta and the implant eventually may result in this life-threa tening complication. Careful follow-up examination and early removal of the implant, if necessary, are important.