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Severe erosion of lumbar vertebral body because of a chronic ruptured abdominal aortic aneurysm.

Aydogan M, Karatoprak O, Mirzanli C, Ozturk C, Tezer M, Hamzaoglu A

Istanbul Spine Center, Florence Nightingale Hospital, Abide-i hurriyet cd. no: 290 sisli, Istanbul 34360, Turkey.

BACKGROUND CONTEXT: Erosion of vertebral bodies because of abdominal aortic aneurysm is an extremely rare condition. This vertebral destruction is usually seen after aortic graft surgery; nevertheless, it is not expected in primary aortic aneurysms. PURPOSE: The purpose of this article was to present a patient who suffers from back and hip pain because of a chronic ruptured primary aortic aneurysm. STUDY DESIGN: Case report. METHOD: A 51-year-old patient had complaints of back pain. Physical examination revealed a pulsatile mass in the periumblical region. By using conventional radiographies, vertebral erosion was detected at the anterior part of L3-L4-L5 vertebrae. A chronic ruptured thrombosed aortic aneurysm was identified by magnetic resonance imaging. RESULTS: After resection of the aneurysm, it was possible that the lack of anterior column support could result in future instability. Therefore, an L4-L5 anterior partial corpectomy and reconstruction of the anterior defect with titanium mesh cage with posterior instrumentation and fusion were performed. CONCLUSION: It was concluded that back pain caused by chronic aortic aneurysms is a rare condition and may be one of the possible etiologies in differential diagnosis of low back pain and/or sciatica in some patients.

Published 26 February 2008 in Spine J, 8(2): 394-6.
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