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Polysegmental spondylodiscitis and concomitant aortic aneurysm rupture: case report with 3-year follow-up period
Oliver Miltner1, Kai Kisielinski, Khaled Chalabi
1Department of Orthopaedic Surgery, University Hospital RWTH Aachen, Aachen, Germany. Miltner.Heuter@t-online.de
Insights
Minimally invasive treatment successfully managed spondylodiscitis and aortic aneurysm rupture in a multimorbid patient. This approach offers an effective alternative for complex cases, improving outcomes in high-risk individuals.
Area of Science:
- Spinal surgery
- Vascular surgery
- Infectious disease
Background:
- Spondylodiscitis (spinal infection) can be complicated by other serious conditions.
- Ruptured abdominal aortic aneurysms can cause neurological deficits.
- Simultaneous treatment for both conditions is rarely reported.
Observation:
- A patient with thoracic and lumbar spondylodiscitis developed a ruptured abdominal aortic aneurysm.
- The patient experienced worsening neurological symptoms.
- The patient was multimorbid and at high risk for surgical complications.
Findings:
- A combined minimally invasive approach was used, including CT-guided drainage for spondylodiscitis and endoluminal stent graft exclusion for the aortic aneurysm.
- Effective treatment of both conditions was achieved.
- The patient showed a successful clinical outcome at 3-year follow-up.
Implications:
- Minimally invasive techniques can be effective for managing complex, co-occurring conditions like spondylodiscitis and aortic aneurysm rupture.
- This approach is a viable alternative to traditional surgery for elderly and multimorbid patients.
- Neurological symptoms in such cases may stem from concurrent illnesses rather than the spinal inflammation alone.
Study Design:
A case report describing a patient with spondylodiscitis of the thoracic and lumbar spine complicated by rupture of an abdominal aortic aneurysm and aggravation of neurologic symptoms is presented.
Objective:
To present a cardiovascular complication worsening the clinical condition during conservative spondylodiscitis therapy, and to describe a minimally invasive treatment regimen for both spondylodiscitis and aortic aneurysm rupture in multimorbid patients at high risk for complications or refusal of surgery.
Summary Of Background Data:
Few articles describe minimally invasive treatment of spondylodiscitis. Some available reports describe neurologic symptoms resulting from spinal cord ischemia in aortic aneurysm rupture. No data were found describing simultaneous therapy for spondylodiscitis and rupture of aortic aneurysm.
Methods:
Therapy consisted of CT-guided percutaneous drainage of the spondylodiscitis and parenteral antibiotic treatment combined with immobilization and minimally invasive endoluminal exclusion of the aortic aneurysm with a bifurcated stent graft.
Results:
Effective therapy for polysegmental spondylodiscitis on the one hand and contained rupture of aortic aneurysm on the other are presented. The successful clinical outcome after conservative orthopedic therapy and vascular intervention has been followed for 3 years.
Conclusions:
In older patients, spondylodiscitis may be complicated by other underlying diseases. Pain and neurologic symptoms may occur secondarily to concomitant illnesses instead of being caused by the inflammation itself. Minimally invasive therapy is shown to be an effective alternative to surgery in older and multimorbid patients with spondylodiscitis and contained aortic aneurysm rupture.