title: Massive vertebral destruction associated with chronic rupture of infrarenal aortic aneurysm: case report and systematic review of the literature in the English language.
abstract: METHODS
  Case report and review of literature.
  
  
  OBJECTIVE
  To highlight the specific features of a rare, life-threatening, clinical picture.
  
  
  BACKGROUND
  Vertebral erosion (VE) is rarely associated with contained rupture of an abdominal aortic aneurysm. The involvement of radicular nerves can mimic a discus hernia syndrome; eventually vertebral erosion induces isolated lower back pain. These features often lead to a delayed or wrong diagnosis of a life-threatening condition. Forty-two complete similar case reports have been published in the English literature since 1962. The most prevalent symptoms are low back pain and neurological signs due to compression of radicular nerves.
  
  
  METHODS
  A 73-year-old man presented to Vascular Surgery department complaining of continuous pain in the lumbar region during the previous 6 months. The duplex examination revealed a huge infrarenal aortic aneurysm with an undefined posterior wall. Spiral CT and MR scan confirmed the aneurysm and a scalloping of the second and third lumbar vertebral bodies.
  
  
  RESULTS
  A double-team intervention, vascular and orthopedic, consisted in aneurysm graft replacement; vertebral bodies excision and anterior and posterior spinal stabilization. Postoperatively the patient experienced reversible respiratory and renal failure and was discharged home in good health after 30 days.
  
  
  CONCLUSIONS
  The presence of aortic abdominal aneurysm is always to be considered in the evaluation of an elderly patient complaining lower back pain or lower limb neuropathy of recent onset, especially in the presence of a degenerative process of the spine.
authors.affiliation: Division of Vascular Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy. vittorio.arici@gmail.com
authors.forename: Vittorio
authors.initials: V
authors.lastname: Arici
authors.forename: Mauro
authors.initials: M
authors.lastname: Rossi
authors.forename: Antonio
authors.initials: A
authors.lastname: Bozzani
authors.forename: Alessia
authors.initials: A
authors.lastname: Moia
authors.forename: Attilio
authors.initials: A
authors.lastname: Odero
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001019:Aortic Rupture / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011859:Radiography; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome