Paraparesis due to pressure erosion of the thoracic spine by an aortic aneurysm: remission of symptoms following resection of the aneurysm and vertebral reconstruction

There are only a few descriptions in the literature of thoraco-abdominal aortic aneurysms responsible for erosion of the vertebral column and compression of the spinal cord. This case is therefore presented to provide an opportunity to discuss the pathomechanic aspects and to demonstrate the feasibi...

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Bibliographic Details
Published in:Acta neurochirurgica 2004-03, Vol.146 (3), p.303-308
Main Authors: Forutan, H, Herdmann, J, Huber, R, Saleh, A, Steiger, H J, Sandmann, W
Format: Article
Language:English
Subjects:
Aneurysms
Aortic Aneurysm, Abdominal - complications
Aortic Aneurysm, Abdominal - surgery
Aortic Aneurysm, Thoracic - complications
Aortic Aneurysm, Thoracic - surgery
Diskectomy
Humans
Male
Middle Aged
Osteonecrosis - complications
Osteonecrosis - surgery
Paraparesis - etiology
Spinal Cord Compression - complications
Spinal Cord Compression - surgery
Spinal Fusion
Surgery
Thoracic Vertebrae - surgery
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Summary:There are only a few descriptions in the literature of thoraco-abdominal aortic aneurysms responsible for erosion of the vertebral column and compression of the spinal cord. This case is therefore presented to provide an opportunity to discuss the pathomechanic aspects and to demonstrate the feasibility of total surgical repair by an interdisciplinary approach. A thoraco-abdominal aortic aneurysm caused extensive erosion of vertebral bodies T5-8, leading to invasion of the spinal canal and compression of the cord. The clinical signs were paraparesis and chronic thoracolumbar pain. In a combined operation the aneurysm was replaced by a Dacron prosthesis. Corpectomy of T5-8 was carried out and a titanium mesh cage filled with autogenous bone tissue was inserted. The vertebral column was stabilized using dorsal and lateral instrumentation. Clinical and imaging follow-up after three years showed remission of the patient's severe paraparesis and chronic pain and long-term technical success of the vertebral and aortic reconstruction. Complete thoraco-abdominal aortic replacement and spinal column repair can be successfully accomplished with good clinical and neurological long-term results.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-003-0210-3