Unstable Spinal Fracture With Arteria Lusoria: Management to Mitigate Aortic Risks

Area of Science:

• Trauma Surgery
• Cardiovascular Surgery
• Neurosurgery

Background:

• Aortic injuries concurrent with unstable spinal fractures present a high mortality risk.
• Multidisciplinary management is critical for preventing fatal complications in these rare cases.

Observation:

• A patient with a D4 vertebral fracture had a fragment near the aortic arch and arteria lusoria.
• Surgical options included high-risk open aortic repair or endovascular repair (TEVAR) with potential anatomical limitations.

Findings:

• The patient underwent spinal stabilization after placement of a Zenith Alpha thoracic aortic prosthesis.
• TEVAR was chosen to secure the vascular injury before spinal surgery, despite potential anatomical challenges.

Implications:

• This case underscores the importance of a tailored, multidisciplinary strategy for managing complex aortic and spinal injuries.
• Prioritizing endovascular aortic repair can mitigate risks associated with open surgery and improve outcomes in selected patients.