Pseudoaneurysm After Spinal Device Migration Treatable
In osteoporotic patient, device migration leads to postoperative development of pseudoaneurysm
THURSDAY, July 17 (HealthDay News) -- Pseudoaneurysm of the aorta due to device migration is a rare but treatable complication following placement of an anterior spinal device, according to an article published in the July issue of The Spine Journal.
Kosaku Higashino, M.D., of the University of Tokushima Graduate School in Tokushima, Japan, and colleagues present a case report of a 70-year-old woman with osteoporosis referred because of migrated anterior spinal devices and a pseudoaneurysm of the thoracoabdominal aorta. This patient had undergone spinal fusion from Th12 to L2 with a smooth rod Kaneda device (SRK).
While the patient had persistent back pain and a gradual migration of devices was noted, no further surgical intervention was performed initially, the researchers note. Increasing low back pain five years postoperatively led to the detection of significantly migrated SRK devices. A computed tomography scan demonstrated a pseudoaneurysm of the thoracoabdominal aorta surrounding the SRK devices. Following pseudoaneurysm resection and repair of the aortic defect with an artificial patch, the migrated SRK devices were removed, the authors report.
"Posterior supplemental fixation or cement augmentation should have been considered if the initial screw fixation was not strong enough in patients with severe osteoporosis," Higashino and colleagues write. "Once the migration of an anterior spinal device was detected, prompt surgical revision should have been undertaken. Careful observation is mandatory until a solid union is ascertained, and scheduled repeat examinations are required after any spine surgery in elderly osteoporotic patients."