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Delayed Penetration of the Thoracic Aorta by Pedicle Screws

A Case Report of Screws Left As-Is

Schermann, Haggai MD∗,†; Mirovsky, Yigal MD; Chechik, Yigal MD

doi: 10.1097/BRS.0000000000003094

Study Design. A case report.

Objective. Presentation of a patient diagnosed with perforation of the aorta by pedicle screws at levels T6 and T9 2 years after spinal fusion, who was advised no intervention. Review of other reported cases that did not undergo excision of the penetrating screws.

Summary of Background Data. More than 30 cases of aortic penetration by pedicle screws were described. Gradual penetration of the screws into the aorta rarely causes symptoms other than backache. However, only two cases were treated conservatively.

Methods. A 65-year-old female patient underwent spinal decompression and T5-T10 posterior fusion following a spinal abscess. Two years and 8 months postoperatively, she underwent a computed tomography scan for suspicion of spinal hardware infection, which showed T6 and T10 screws penetrating the thoracic aorta.

Results. Due to high morbidity, the patient was not offered an operation for screw excision.

Conclusion. This case report adds to the only two previous reports of patients who did not undergo revision of pedicle screws penetrating thoracic aorta.

Level of Evidence: 5

Several cases of pedicle screw penetration into aorta were described. Some of them, including the presented case, were allowed to remain in place and did not cause additional complications.

Department of Orthopedic Surgery, Assaf Harofeh Medical Center, Zerifin

Division of Orthopedics, Tel-Aviv Sourasky Medical Center, affiliated with Tel Aviv University, Tel Aviv, Israel.

Address correspondence and reprint requests to Haggai Schermann, MD, 6 Weizmann St, Tel Aviv, Israel; E-mail:

Received 12 December, 2018

Revised 2 March, 2019

Accepted 8 April, 2019

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

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