Vertebral destruction due to abdominal aortic aneurysm

Pinheiro, J.F.J. Viseu; Blanco, Juan F.; Hernández, D. Pescador; García, Francisca

doi:10.1016/j.ijscr.2014.12.001

Cited by 10 publications

(8 citation statements)

References 14 publications

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“…Our case is unique in this regard. Furthermore, low back pain has been a well‐documented presentation of an unruptured AAA in several case reports 19–25 …”

Section: Discussionmentioning

confidence: 99%

Abdominal aortic aneurysm presenting to the orthopedic clinic as posterior hip and low back pain

Marcel

Jovan

Myrick

2023

Clinical Case Reports

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An abdominal aortic aneurysm (AAA) is a permanent dilatation of the infrarenal aorta that is 3 cm or greater in diameter or equivalent to 1.5 times the normal anteroposterior diameter. 1,2 Risk factors for AAA include smoking, male sex, age greater than 65 years old, high systolic blood pressure, high body mass index, high serum triglycerides, high lowdensity lipoprotein, family history of AAA, coronary artery disease (CAD), atherosclerosis, stroke, and diabetes mellitus with concomitant CAD and peripheral artery disease (PAD). [3][4][5][6][7][8] Of these, smoking is the greatest contributor to the development of AAA. 3,4,9 In smokers, growth rate increases by an additional 0.35 mm/year and rupture rate doubles. 7 Most unruptured AAAs are asymptomatic and are found incidentally while investigating some other pathology. 4,5,7,10 However, when symptomatic, unruptured AAA may present with unexplained abdominal discomfort and pain that radiates to the back, flank, or groin, as well as a pulsatile abdominal mass with or without a bruit heard at the mass. 4,11 The generalized pain from a symptomatic AAA may be confused with an orthopedic etiology. A patient presenting with what seems to be a musculoskeletal (MSK)

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“…Our case is unique in this regard. Furthermore, low back pain has been a well‐documented presentation of an unruptured AAA in several case reports 19–25 …”

Section: Discussionmentioning

confidence: 99%

Abdominal aortic aneurysm presenting to the orthopedic clinic as posterior hip and low back pain

Marcel

Jovan

Myrick

2023

Clinical Case Reports

View full text Add to dashboard Cite

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“…Several hypotheses have been formed regarding the mechanism of vertebral erosion; arterial pulse, hematoma infection, other infl ammatory cause. 5 The latest hypothesis suggests that the infl ammatory reaction from the resultant blood products in the retroperitoneal space may result in vertebral body erosive changes. 6,7 It is essential to differentiate vertebral erosion caused by an aortic aneurysm or infection.…”

Section: Discussionmentioning

confidence: 99%

Contained rupture of an infected abdominal aneurysm eroding into the L4 vertebra in a patient after aorto-femoral reconstruction

Novotný¹,

Janoušek²,

Chlupáč³

et al. 2020

Cor Vasa

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Chronická ohraničená ruptura břišního aneurysmatu (AAA) erodující do obratlů je relativně neobvyklá. Jedním z projevů kromě pulsující břišní rezistence může být nespecifi cká bolest v dolní části zad. Kazuistika: Sedmdesátiletý pacient, muž po pravém aortofemorálním protetickém bypassu (RAFB) před jedenácti lety, byl předán do našeho centra s nespecifi ckou bolestí dolní části zad, která trvala posledních 12 hodin. Výpočetní tomografi cká angiografi e (CTA) odhalila prasklé AAA 57 × 63 mm erodující do obratle L4. U pacienta byla naplánována chirurgická intervence. Mikrobiologické vyšetření kultury z AAA následně prokázalo infekci Staphylococcus hominis. Po zákroku byla u pacienta zahájena třítýdenní antibiotická terapie linezolidem. Výsledky: V současné době máme tříměsíční sledování u pacienta bez známek infekce v protetické náhradě infrarenální aorty na základě ultrazvuku. Závěr: Bolest dolní části zad je častá lékařská diagnóza. Jejím důvodem však nemusí být vždy primární onemocnění páteře. Chronické prasklé AAA s erozí vertebrálních obratlů je neobvyklým projevem prasklého AAA.

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“…Previous articles have highlighted the incidence of atypical back pain and subsequent vertebral lysis and pain due to an AAA 26 and the indication of AAA repair due to the proximity of a large osteophyte in the lumbar spine 27 ; however, this is the first instance of a combined technique. In one of these studies, only the AAA was repaired, with the large osteophyte not requiring treatment, and in the other the vertebral bodies were stabilized with pedicle screws, while the AAA was left due to healthy renal arteries and distal flow from collaterals.…”

Section: Discussionmentioning

confidence: 99%

Combined Aorto-Iliac and Anterior Lumbar Spine Reconstruction: A Case Series

et al. 2018

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Background: Treatment options for aortic-iliac pathology may include endovascular repair and open surgical repair. Treatment options for degenerative disc disease (DDD) are varied but commonly include anterior reconstruction. When both the aortic-iliac and spinal pathologies are significant and surgical intervention is indicated for each pathology, the opportunity exists for concurrent treatment of both the aortic-iliac pathology and DDD in the same operation. The purpose of this case series was to document the safety and feasibility of a surgical strategy whereby a combined elective reconstructive procedure was performed for aortic and anterior lumbar spinal pathologies.Methods: The case histories of 5 patients who were treated for both spinal and vascular pathology are presented. Surgical outcome measures included operative time, blood loss, length of stay, and complications. Spine-specific outcome measures included Oswestry Disability Index, Roland Morris Disability Questionnaire, and visual analogue scores (back and leg).Results: The spinal reconstructions performed included 1 L4-5 total disc replacement (TDR), 1 L4-5, L5-S1 anterior lumbar interbody fusion (ALIF), 1 L5-S1 ALIF, and 2 hybrid procedures (L4-5 TDR with L5-S1 ALIF). Vascular reconstructions included 4 aorto-bi-iliac bypass grafts and 1 aortic tube graft. The average operative time was 365 minutes (ranging between 330 and 510 minutes), the average blood loss was 1699 mL (range between 1160 and 2960 mL), and the average length of hospital stay was 14 days (range from 8 to 22 days). There were no in-hospital complications, and all patients experienced significant improvement in both back and leg pain. One patient developed kinking of the iliac limbs of the vascular graft 1 year postoperatively, which was managed with endovascular stenting of the graft.Conclusions: Aortic-iliac pathology and DDD are significant pathologies often treated in isolation. This study illustrates that, despite its complexity, highly trained individuals in a specialized setting can perform combined surgery to achieve a satisfactory outcome for the patient.Level of Evidence: Level IV evidence. Lumbar SpineKeywords: abdominal aortic aneurysm, total disc arthroplasty, anterior lumbar interbody fusion, aortic iliac occlusive disease, multidisciplinary approach by guest on July 5, 2020 http://ijssurgery.com/ Downloaded from Abbreviations: VAS, visual analogue score; ODI, Oswestry Disability Index; RMDQ, Roland Morris Disability Questionnaire.

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Vertebral destruction due to abdominal aortic aneurysm

Cited by 10 publications

References 14 publications

Abdominal aortic aneurysm presenting to the orthopedic clinic as posterior hip and low back pain

Abdominal aortic aneurysm presenting to the orthopedic clinic as posterior hip and low back pain

Contained rupture of an infected abdominal aneurysm eroding into the L4 vertebra in a patient after aorto-femoral reconstruction

Combined Aorto-Iliac and Anterior Lumbar Spine Reconstruction: A Case Series

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