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The combination of abdominal aortic aneurysm (AAA) and necrosis of the lumbar vertebral bodies is often the consequence of ischemia of the lumbar arteries and local compression from the aneurysm. A patient with necrosis of lumbar vertebral bodies 2 to 4 was admitted for abdominal aneurysm repair. CT scanning revealed almost complete destruction of the second and fourth lumbar vertebral bodies. In a combined operation an orthopedic and a vascular surgical team implanted two carbonic cages with autogenous splinter of the pelvic bone and an aortic vascular graft, using a retroperitoneal approach. Three months after the operation the 61-year-old man is entirely well and without any signs of back pain. He could be fully mobilized within 3 weeks postoperatively. This case study depicts the surgical techniques and discusses the advantages of the simultaneous operation and retroperitoneal exposure.

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