Polysegmental spondylodiscitis and concomitant aortic aneurysm rupture: case report with 3-year follow-up period.
METHODS
A case report describing a patient with spondylodiscitis of the thoracic and lumbar spine complicated by rupture of an abdominal aortic aneurysm and aggravation of neurologic symptoms is presented.


OBJECTIVE
To present a cardiovascular complication worsening the clinical condition during conservative spondylodiscitis therapy, and to describe a minimally invasive treatment regimen for both spondylodiscitis and aortic aneurysm rupture in multimorbid patients at high risk for complications or refusal of surgery.


BACKGROUND
Few articles describe minimally invasive treatment of spondylodiscitis. Some available reports describe neurologic symptoms resulting from spinal cord ischemia in aortic aneurysm rupture. No data were found describing simultaneous therapy for spondylodiscitis and rupture of aortic aneurysm.


METHODS
Therapy consisted of CT-guided percutaneous drainage of the spondylodiscitis and parenteral antibiotic treatment combined with immobilization and minimally invasive endoluminal exclusion of the aortic aneurysm with a bifurcated stent graft.


RESULTS
Effective therapy for polysegmental spondylodiscitis on the one hand and contained rupture of aortic aneurysm on the other are presented. The successful clinical outcome after conservative orthopedic therapy and vascular intervention has been followed for 3 years.


CONCLUSIONS
In older patients, spondylodiscitis may be complicated by other underlying diseases. Pain and neurologic symptoms may occur secondarily to concomitant illnesses instead of being caused by the inflammation itself. Minimally invasive therapy is shown to be an effective alternative to surgery in older and multimorbid patients with spondylodiscitis and contained aortic aneurysm rupture.
Miltner
Oliver
O
Department of Orthopaedic Surgery, University Hospital RWTH Aachen, Aachen, Germany. Miltner.Heuter@t-online.de
Kisielinski
Kai
K
Chalabi
Khaled
K
Niedhart
Christopher
C
Siebert
Christian H
CH
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001019:Aortic Rupture / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D001416:Back Pain / Q000209:etiology; D019917:Blood Vessel Prosthesis Implantation; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D015299:Discitis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D004322:Drainage; D004381:Duodenal Ulcer / Q000150:complications; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D020760:Spinal Cord Ischemia / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015607:Stents; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D000900:Anti-Bacterial Agents