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aortic_lesion

The coexistence of an unstable spinal fracture with a pending aortic lesion is potentially catastrophic and a therapeutic challenge as to timing of treatment, assigning priorities and selecting the best approach.

A 41 year-old healthy male victim of bike accident. Imaging revealed a fracture of 6th and 7th thoracic vertebrae with a bone fragment in close proximity to the descending thoracic aorta. After consultation with spine/vascular surgeons and interventional radiologists it was decided to secure the potential aortic injury with an endovascular stent-graft followed by posterior vertebral instrumentation for fracture's reduction.

A multi-specialists teamwork approach is mandatory. Vascular lesion is priority, followed by vertebral surgery. As to the treatment options, we suggest a “best but still safest” philosophy: endovascular repair and posterior spinal instrumentation should be considered first in the acute stage 1).

1)
Cultrera F, Gamberini E, Iacono G, Turicchia GU, Agnoletti V, Tosatto L. Unstable thoracic spine fracture with aortic encroachment: A potentially fatal association and a suggested treatment. Int J Surg Case Rep. 2017 Aug 18;39:181-184. doi: 10.1016/j.ijscr.2017.08.015. [Epub ahead of print] PubMed PMID: 28846951.
aortic_lesion.txt · Last modified: 2017/08/29 16:52 by administrador