title: An endovascular treatment of a thoracic aortic injury caused by a misplaced pedicle screw: Case report and review of the literature.
abstract: Aortic injuries are devastating complications after spinal surgery. We here would like to share our experience with a successful endovascular treatment of an iatrogenic thoracic aortic injury caused by misplaced pedicle screw after spinal surgery. A patient underwent posterior spinal surgery for L1 burst fracture was transferred to our department for instrumentation removal. An iatrogenic thoracic aortic injury at T11 level caused by a pedicle screw was recognized after routine CT scans. Complete screw extraction and instrumentation removal were performed after the placement of a thoracic aortic stent graft covering the injured region. The patient had an uneventful postoperative period and no complications were observed in the 1 and 12-month follow-up by contrast-enhanced CT scans. For the delayed thoracic aortic injuries which usually were usually shown on CT scans as pseudoaneurysm or penetration of the aorta, stent graft implantation would provide a preferred solution with high-effectiveness, low-invasiveness and fewer complications compared with conventional open surgery.
authors.affiliation: Department of Orthopedic Surgery, The 1st Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Tong
authors.affiliation: Department of Orthopedic Surgery, The 1st Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Pengcheng
authors.initials: P
authors.lastname: Gu
authors.affiliation: Department of Orthopedic Surgery, The 1st Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Yu
authors.affiliation: Department of Orthopedic Surgery, The 1st Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Guo
authors.affiliation: Department of Orthopedic Surgery, The 1st Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. Electronic address: xiangjin.lin.2013@gmail.com.
authors.forename: Xiangjin
authors.initials: X
authors.lastname: Lin
mesh_terms: D017541:Aneurysm, False; D001013:Aorta, Thoracic / Q000293:injuries* / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D065289:Pedicle Screws / Q000009:adverse effects*; D016103:Spinal Fractures / Q000601:surgery*; D015607:Stents; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: iatrogenic thoracic injury; spinal surgery; stent graft