Delayed Presentation of a Thoracic Aortic Injury With a Vertebral Pedicle Screw

Aortic Dissection Associated with Penetration of a Spinal Pedicle Screw: A Case Report and Review of the Literature

“…In other cases, as in our case, there is a gradual shifting of the pedicle screw toward a vessel, and penetration happens and worsens over time . In most of these cases, the misaligned screw is discovered incidentally.…”

“…13 In other cases, as in our case, there is a gradual shifting of the pedicle screw toward a vessel, and penetration happens and worsens over time. 12 In most of these cases, the misaligned screw is discovered incidentally. In some cases, the gradual movement of the screw is evident on serial imaging, and intervention to correct the problem is undertaken before the aorta is actually penetrated.…”

Delayed Presentation of Aortic Injury by a Thoracic Pedicle Screw

“…The incidence of late presentation is much lower. So far, 38 cases of delayed (≥30 days) presentation of aortic injury by pedicle screws have been reported in the English literature . Table summarizes the presentations and clinical characteristics of these patients.…”

Unstable thoracic spine fracture with aortic encroachment: A potentially fatal association and a suggested treatment

“…While several papers describe the occurrence and treatment of aortic lesions secondary to spinal surgery [7] , [8] , [9] , [10] , [11] there are few reports focusing on the management of unstable vertebral column fractures with a concomitant or potential aortic injury [3] , [6] , [12] , [13] , [14] . Such cases pose a real therapeutic dilemma as to the optimal timing for treatment, the priorities to be assigned and the most adequate procedures to be adopted.…”

“…The decision-making process requires a close multidisciplinary cooperation between spine/vascular surgeons and interventional radiologists with proper consideration given to individual cases [6] , [7] , [9] , [10] . The actual or potential vascular lesion takes absolute precedence [3] , [6] , [7] , [12] , [14] . Open, direct surgical repair (via thoracotomy) and endovascular treatment are alternative options followed by surgical reduction of the fracture.…”