Severe erosion of lumbar vertebral body because of abdominal aortic false aneurysm: report of two cases.
METHODS
Two cases of lumbar vertebral erosion resulting from abdominal aortic false aneurysm are reported.


OBJECTIVE
To present an uncommon complication of aortic endoprosthesis causing spinal pathology.


BACKGROUND
Vertebral body pathologies usually are associated with fracture, osteoporotic collapse, tumor, spondylitis, or spondylodiscitis. Aortic abdominal aneurysm rarely has been reported as causing lytic lesions of the spine.


METHODS
A retrospective case analysis was performed for two patients with an aorta bifurcation prosthesis and lytic lesions of the spine. False aneurysms were detected at the proximal junction of the prostheses. A biopsy of the affected vertebrae showed no infection or malignancy. Surgery was performed in both cases, and the prostheses were successfully revised. In one case, an anteroposterior spinal fusion was performed because of severe anterior bone loss.


RESULTS
The back pain of both patients resolved completely after surgery. In one of the patients, an embolectomy in the right leg failed, and a below-the-knee amputation had to be performed.


CONCLUSIONS
In patients with endovascular prostheses, false aneurysm should be considered when lytic lesions of vertebral bodies are differentially diagnosed because these patients can present with only spinal symptoms.
Departments of Orthopedics and; Vascular Surgery, University Medical Center Utrecht, The Netherlands.
C H
CH
Diekerhof
R W H
RW
Reedt Dortland
F C
FC
Oner
A J
AJ
Verbout
D000368:Aged; D000671:Amputation, Surgical; D017541:Aneurysm, False / Q000150:complications / Q000175:diagnosis*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis*; D001416:Back Pain / Q000209:etiology; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D004378:Duodenal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D004617:Embolism / Q000209:etiology; D006396:Hematemesis / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D007866:Leg / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008297:Male; D008551:Melena / Q000209:etiology; D008875:Middle Aged; D013122:Spinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome