Lumbar artery pseudoaneurysm as a late complication of osteomyelitis with vertebral body destruction

Tomescot, Andre; Dallaudière, B.; Zurlinden, Olivier; Manelfe, J.

doi:10.1016/j.jvs.2012.12.070

Cited by 8 publications

(6 citation statements)

References 16 publications

(22 reference statements)

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“…These vessels form supply to lumbar vertebrae, adjoining muscles, a distal portion of spinal cord and nerve roots of cauda equine [3,4]. Lumbar artery aneurysms (Table 1) have been reported following penetrating trauma [2], blunt trauma and iatrogenic type including percutaneous kidney procedures, laparoscopic splenectomy [1], lumbar posterolateral fusion [5] vertebral osteomyelitis [6].…”

Section: Discussionmentioning

confidence: 99%

Lumbar artery pseudoaneurysm following blunt trauma: A case report and literature review

Vashisht

Bachhal

Kumar

et al. 2019

Trauma Case Reports

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Lumbar artery pseudoaneurysms following blunt trauma are very rare. We report a case of polytrauma patient having lumbar spine injury and pelvic fracture presenting with hemodynamic instability. The patient did not improve after aggressive resuscitation. There was no evidence of intraabdominal solid organ or visceral injury. We suspected injury to pelvic vessels as a source of bleeding. Computed tomography (CT) angiography was done. A small size (6 × 5 mm) lobulated hyperdense structure is seen in the territory of a left 4th lumbar branch of aorta suggestive of a pseudoaneurysm. Whenever there is a patient of blunt abdominal trauma with pelvic or spine injury and source of bleeding cannot be established, lumbar vessels as a source of bleeding should be kept in mind. CT angiography must be done for diagnosis and patient may subsequently need angioembolization of these vessels.

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Section: Discussionmentioning

confidence: 99%

Lumbar artery pseudoaneurysm following blunt trauma: A case report and literature review

Vashisht

Bachhal

Kumar

et al. 2019

Trauma Case Reports

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“…They may present acutely with hemodynamic instability in the setting of an expanding retroperitoneal hematoma [ 6 , 7 ], or they may present 1–2 weeks after the inciting injury [ 2 , 4 , 5 ]. Some reports document presentations delayed for months [ 3 ] or even years after the initial injury [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed presentation of a lumbar artery pseudoaneurysm resulting from isolated penetrating trauma

et al. 2015

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Lumbar artery pseudoaneurysms are infrequent complications of penetrating trauma. When present, they are often accompanied by other injuries; however, we report the case of an isolated traumatic lumbar artery aneurysm resulting from a single knife stab. The lesion was successfully treated with endovascular microcoil embolization. While these injuries are uncommon, the surgeon must maintain a high index of suspicion, even with seemingly uncomplicated injuries, as a missed traumatic pseudoaneurysm may be life threatening.

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“…and iatrogenic trauma such as complication of vertebral biopsy, lumbar disc surgery, and laparoscopic surgery 16,17,19) . A pseudoaneurysm can develop even without a direct vascular injury during surgery, owing to potential harm to the blood vessels surrounding the surgical area 10,14) .…”

Section: A a B Bmentioning

confidence: 99%

“…These surgical procedures are commonly employed in typical spinal surgeries. However, it is essential to be cautious, as surgical trauma and the inflammatory process can potentially cause damage to infected fragile tissues, including blood vessels 19) . A secondary surgery is not uncommon when spondylitis is not effectively controlled even after the first surgery.…”

Section: Introductionmentioning

confidence: 99%

An Intravertebral Pseudoaneurysm Formed after Infective Spondylitis

Kim,

Kang,

Park

et al. 2023

Nerve

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The surgical treatment of spondylitis involves potential risks, especially when dealing with infected tissues that may be fragile and susceptible to injury from surgical trauma and inflammation. In cases where spondylitis is not controlled even after the initial surgery, unexpected situations can arise if an unusual change in infected tissues around the spine is misinterpreted. The present case involves a 62-year-old who underwent laminectomy, debridement, and stabilization from T12 to L2 due to medically intractable spondylitis caused by methicillin-resistant Staphylococcus aureus. No major bleeding or vascular injury occurred during surgery. However, despite some improvement in pain and weakness, inflammation markers remained elevated and back pain recurred. A computed tomography (CT) scan taken 15 days after surgery showed a round-enhancing lesion inside the L1 vertebra. Although the primary imaging diagnosis suggested a loculated abscess, a round-enhancing lesion raised suspicion of an unusual pseudoaneurysm. A CT angiography confirmed a pseudoaneurysm from the L1 segmental artery, successfully treated with endovascular embolization. After embolization, the patient’s back pain improved, and inflammation markers further decreased with oral antibiotics. This case highlights the possibility of a pseudoaneurysm occurring in cases of spondylitis, emphasizing the importance of considering this entity in the differential diagnosis to ensure proper treatment.

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Lumbar artery pseudoaneurysm as a late complication of osteomyelitis with vertebral body destruction

Cited by 8 publications

References 16 publications

Lumbar artery pseudoaneurysm following blunt trauma: A case report and literature review

Lumbar artery pseudoaneurysm following blunt trauma: A case report and literature review

Delayed presentation of a lumbar artery pseudoaneurysm resulting from isolated penetrating trauma

An Intravertebral Pseudoaneurysm Formed after Infective Spondylitis

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