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Delayed aortic rupture caused by an implanted anterior spinal device. Case report.
T Ohnishi1, M Neo, M Matsushita
1Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Japan.
Journal of Neurosurgery
|October 16, 2001
Summary
Delayed aortic rupture is a rare complication of spinal fusion surgery using the smooth-rod Kaneda (SRK) instrument. This case highlights the importance of monitoring patients for potential life-threatening issues related to spinal implants.
Area of Science:
- Spinal Surgery
- Cardiovascular Complications
- Medical Device Complications
Background:
- Anterior spinal fusion is a surgical procedure to treat spinal fractures and instability.
- Instrumentation, such as the smooth-rod Kaneda (SRK) device, is often used to stabilize the spine during fusion.
- Complications, though rare, can arise from the placement of spinal implants.
Observation:
- A 53-year-old male with a T-11 fracture and paraparesis underwent anterior spinal fusion with an SRK device and iliac bone graft.
- Postoperatively, neurological deficits resolved, but nonunion led to progressive kyphosis.
- Twenty months later, the patient developed gastrointestinal symptoms, revealing a delayed aortic rupture with a pseudoaneurysm near the implant.
Findings:
- The patient underwent surgical repair of the aortic pseudoaneurysm and immediate removal of the SRK device.
- This case represents a rare instance of delayed aortic rupture associated with anterior spinal instrumentation.
- The findings underscore the potential for life-threatening complications due to the proximity of implants to the aorta.
Implications:
- Careful patient follow-up is crucial after anterior spinal fusion with instrumentation.
- Early detection and, if necessary, removal of implants may mitigate risks of severe complications.
- Continued vigilance is warranted despite improvements in surgical techniques and implant design.