Laceration of Abdominal Aorta by a Fragment of Fractured L2 Vertebral Body After a Low-Energy Injury

Sławomir Dudko, MD, PhD; Damian Kusz, MD, PhD; Damian Ziaja, MD, PhD; Błażej Kusz, MD

Disclosures

Spine. 2012;37(22):E1406-E1409. 

In This Article

Abstract and Introduction

Abstract

Study Design. A rare case of direct injury to the wall of abdominal aorta caused by a displaced fracture of the L2 vertebral body resulting from a low-energy injury. Potential injury mechanism and predisposing factors are discussed along with a review of literature pertaining to the subject.
Objective. To describe a unique case of direct aortic wall injury caused by a displaced vertebral body fracture.
Summary of Background Data. The literature on aortic wall injuries after vertebral fractures is reviewed. So far, only the injuries of the thoracic aorta were extensively described. Injuries of the abdominal aorta are much less frequent and usually associated with high-energy trauma. However, coexisting disorders, predisposing the patient to thoracolumbar vertebral body fractures (e.g., osteoporosis, chronic alcoholism) and aortic wall injuries (atherosclerosis) make aforementioned complication possible, despite the low-energy mechanism of injury.
Methods. A clinical and radiographical interpretation of the reported case is presented.
Results. Laceration of abdominal aorta was caused by a sharp, anteriorly displaced bone fragment of the fractured L2 vertebral body.
Conclusion. The reported case adds to the literature on vertebral fractures by describing another mechanism leading to aortic wall disruption. Similar vascular complications may be identified more frequently in the future given the high prevalence of osteoporosis and atherosclerosis in the general population.

Introduction

Abdominal aorta lacerations are very rare in nonpenetrating injuries and are usually caused by high-energy trauma. To our knowledge, this is the first description of a low-energy vertebral fracture complicated by laceration of the aortic wall by a bone fragment of the fractured vertebral body. Although regarded as a theoretically possible scenario, such a case has never been presented in the literature to date.

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