title: Endovascular treatment of an iatrogenic thoracic aortic injury after spinal instrumentation: case report.
abstract: Iatrogenic aortic injuries after spinal surgery have been described, but are rare. We describe a case of a 77-year-old woman who underwent surgical correction of a debilitating spinal deformity at an outside institution. Postoperative thoracic spine radiographs and computed tomography scans revealed a misplaced pedicle screw at T5, which was impinging on the descending thoracic aortic wall. The patient was brought to the operating room, where a thoracic stent graft was deployed under fluoroscopic guidance as the malpositioned screw was manually retracted. The patient had an uneventful postoperative course, and was discharged within 24 hours. This case represents a rare but potentially morbid vascular complication of spinal instrumentation surgery that was successfully treated without the need for thoracotomy.
authors.affiliation: Department of Surgery, Division of Vascular Surgery, The Mount Sinai School of Medicine, New York, NY 10029, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Minor
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Morrissey
authors.forename: Richard
authors.initials: R
authors.lastname: Peress
authors.forename: Alfio
authors.initials: A
authors.lastname: Carroccio
authors.forename: Sharif
authors.initials: S
authors.lastname: Ellozy
authors.forename: Gautam
authors.initials: G
authors.lastname: Agarwal
authors.forename: Victoria
authors.initials: V
authors.lastname: Teodorescu
authors.forename: Larry H
authors.initials: LH
authors.lastname: Hollier
authors.forename: Michael L
authors.initials: ML
authors.lastname: Marin
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D001863:Bone Screws / Q000009:adverse effects*; D020878:Device Removal / Q000379:methods; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000295:instrumentation; D012600:Scoliosis / Q000601:surgery; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000209:etiology / Q000601:surgery*