Severe erosion of lumbar vertebral body because of abdominal aortic false aneurysm: report of two cases.

STUDY

DESIGN

Two cases of lumbar vertebral erosion resulting from abdominal aortic false aneurysm are reported.

OBJECTIVE

To present an uncommon complication of aortic endoprosthesis causing spinal pathology.

SUMMARY OF BACKGROUND DATA: Vertebral body pathologies usually are associated with fracture, osteoporotic collapse, tumor, spondylitis, or spondylodiscitis. Aortic abdominal aneurysm rarely has been reported as causing lytic lesions of the spine.

METHODS

A retrospective case analysis was performed for two patients with an aorta bifurcation prosthesis and lytic lesions of the spine. False aneurysms were detected at the proximal junction of the prostheses. A biopsy of the affected vertebrae showed no infection or malignancy. Surgery was performed in both cases, and the prostheses were successfully revised. In one case, an anteroposterior spinal fusion was performed because of severe anterior bone loss.

RESULTS

The back pain of both patients resolved completely after surgery. In one of the patients, an embolectomy in the right leg failed, and a below-the-knee amputation had to be performed.

CONCLUSIONS

In patients with endovascular prostheses, false aneurysm should be considered when lytic lesions of vertebral bodies are differentially diagnosed because these patients can present with only spinal symptoms.