Key result
TEVAR successfully repairs a life-threatening iatrogenic aortic injury from a pedicle screw in an adolescent.
Why the study?
Management strategies for iatrogenic aortic injury during thoracic kyphosis surgery in adolescents are not well established.
Case Report (n=1)
TEVAR is a viable, minimally invasive rescue strategy for life-threatening iatrogenic aortic injuries during spinal instrumentation surgery in adolescents.
Answers are grounded in this paper and cite their sources.
Supports TEVAR consideration for rare adolescent iatrogenic aortic injury; leaves open need for prospective outcome data.
A patient in his early adolescence, who was treated for T5-T6 tubercular spondylodiscitis with an un-instrumented decompression, presented at 36 months post-index surgery, for post-laminectomy instability and kyphosis, after completing his requisite antitubercular treatment. He underwent thoracic posterior instrumented kyphosis correction and anterior reconstruction, with a T5-T6 partial corpectomy and corpectomy spacer placement, through a posterior midline incision. On the second postoperative day, he started complaining of pain on the left side of his chest, abdomen and left shoulder. On contrast-enhanced CT evaluation, one of the pedicle screws was found to be impinging on the aortic wall, with contrast opacification in the left hemithorax. After resuscitation, he underwent a minimally invasive endovascular procedure (thoracic endovascular aortic repair, TEVAR), circumventing the need for a complex and morbid open thoracic repair in an adolescent. Post-TEVAR, the pedicle screw realignment was done. The patient has now returned to full daily activities and a normal schooling.
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Mehra et al. (2025) conducted a case report in Iatrogenic aortic injury during thoracic kyphosis surgery (n=1). Thoracic endovascular aortic repair (TEVAR) was evaluated on Clinical recovery and return to daily activities. Thoracic endovascular aortic repair (TEVAR) successfully managed a life-threatening iatrogenic aortic injury from a pedicle screw in an adolescent, allowing return to normal daily activities.
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