title: Trachea-thoracic vertebral body fistula causing spinal cord injury: a case report.
abstract: METHODS
  A case report and review of the literature.
  
  
  OBJECTIVE
  To discuss the significance of identifying trachea-thoracic vertebral body fistula.
  
  
  BACKGROUND
  Several authors have reported the occurrence of communication between the trachea and the spinal canal or paraspinal abscess. However, trachea-thoracic vertebral body fistulas have not been reported.
  
  
  METHODS
  A 77-year-old male experienced gradually worsening lower-extremity palsy. Fifteen years before presentation, he had undergone retrosternal esophageal reconstruction with a gastric tube for esophageal cancer.
  
  
  RESULTS
  Computed tomographic scan revealed compression of the Th5 vertebral body; the trachea and the Th5 vertebral body were connected by a fistula, and air seemed to enter Th5 from the trachea. Magnetic resonance image showed severe spinal canal stenosis. Posterior thoracic decompression and fusion was performed. Five months after the procedure, he regained the ability to walk with a cane, and computed tomographic scan revealed closure of the fistula and the bony fusion.
  
  
  CONCLUSIONS
  To our knowledge, this is the first case report of a trachea-thoracic vertebral body fistula. Because the trachea is adjacent to the anterior aspect of the thoracic vertebrae, in cases of retrosternal esophageal reconstruction, trachea-vertebral body fistula should be a differential diagnosis for destructive changes in thoracic vertebrae without any signs of trauma.
authors.affiliation: *Department of Orthopaedic Surgery, School of Medicine, Gifu University, Gifu, Japan †Department of Reconstructive Surgery for Spine, Bone, and Joint, Gifu University Graduate School of Medicine, Gifu, Japan; and ‡Spine Center, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shimokawa
authors.forename: Kei
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Hioki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Masuda
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Akiyama
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D019299:Decompression, Surgical; D006801:Humans; D008297:Male; D016156:Respiratory Tract Fistula / Q000150:complications* / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology* / Q000628:therapy; D013119:Spinal Cord Injuries / Q000209:etiology* / Q000601:surgery; D013122:Spinal Diseases / Q000150:complications* / Q000601:surgery; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery; D014133:Tracheal Diseases / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome