Abdominal Aortic Aneurysm: An Overlooked Etiology of Low Back Pain

Abstract

Low back pain is very common and the vast majority of cases are related to non-specific etiologies. Low back pain due to serious pathologies is very rare. We present the case of a 66-year-old man with progressively worsening low back pain. His past medical history was remarkable for poorly controlled hypertension, diabetes mellitus, and dyslipidemia. He had several visits to the outpatient clinics and was diagnosed as having low back pain due to musculoskeletal etiology. He was prescribed multiple oral non-steroidal antiinflammatory drugs and underwent multiple sessions of physiotherapy. However, his condition progressed, and did not show any clinical improvement. He underwent a plain radiograph of the lumbosacral spine which revealed decreased intervertebral disc spaces with multiple osteophytes. However, aneurysmal dilatation of the abdominal aorta was noted with atheromatous calcification. Computed tomography angiography confirmed the diagnosis of abdominal aortic aneurysm. The patient underwent endovascular repair of the aneurysm. The patient had complete resolution of his low back pain and remained symptomfree after six months of follow-up. The present case highlighted that those common presentations such as low back pain can be indicative of serious underlying pathology. Early diagnosis and management of abdominal aortic aneurysms can improve the prognosis and survival.

Association of abdominal aortic calcification and lower back pain in patients with degenerative spondylolisthesis

“…35 This idea is further supported by case reports of intense LBP in patients with obstructive aortic abdominal aneurysms. 1,12…”

“…35 This idea is further supported by case reports of intense LBP in patients with obstructive aortic abdominal aneurysms. 1,12 Research regarding the effect of AAC in patients undergoing spinal surgery is sparse. One study by Sakaura et al demonstrated a significant association between AAC and increased risk of adjacent segment disease after lumbar fusion surgery 24 and less improvement in disability after surgery.…”