Aortic intramural hematoma after transpedicular thoracic spine fusion

A 55-year-old patient M. with compression fractures of Th7-Th8 underwent Th7-Th8 decompressive laminectomy, Th6-Th9 transpedicular spine fusion procedure on January 31, 2017. After that, multiple myeloma was diagnosed at the National Research Center for Hematology. Computed tomography revealed misplacement of a left Th6 screw, its anterior cortical perforation and penetration into the aorta. Signs of intramural hematoma were noticed in this area. The patient was referred to the Petrovsky National Research Center of Surgery. Two-stage surgical approach was preferred. Endovascular repair of the thoracic aorta (TEVAR) was followed by revision of transpedicular fusion system and reinstallation of the screw. Operation was performed on July 14, 2017. Postoperative period was uneventful.