Skip to main content

Advertisement

Log in

Aortic issues in scoliosis and scoliotic operations

  • review article
  • Published:
Wiener klinische Wochenschrift Aims and scope Submit manuscript

Summary

The spatial relations between the aorta and vertebrae are changing with posture, surgical techniques, and operative maneuvers. “Risky screws” (within 1–3 mm proximity to the aorta or other adjacent tissues) were found in 5.8–15.2 % screws. In order to avoid early and later aortic complications secondary to scoliotic operations, careful preoperative metrology of aorto-vertebrae relations is of crucial importance. Compared with patients with idiopathic scoliosis, Marfan-related scoliosis is characterized by faster progression and it is more bracing-resistant due to the particular developmental anomalies in Marfan syndrome, implying the refractory nature of the latter. The present study aims to highlight the clinical impact of preoperative aorto-vertebra metrology in the scoliotic operations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Tidy C. Scoliosis and kyphosis. http://www.patient.co.uk/doctor/scoliosis-and-kyphosis. Accessed 15 April 2015.

  2. de Baat P, Biezen FC van, de Baat C. Scoliose: overzicht van typen, oorzaken, diagnostiek en behandeling 1. Ned Tijdschr Tandheelkd. 2012;119:477–81. doi:10.5177/ntvt.2012.10.12210.

    Google Scholar 

  3. de Baat P, Biezen FC van, de Baat C. Scoliose: overzicht van typen, oorzaken, diagnostiek en behandeling 2. Ned Tijdschr Tandheelkd. 2012;119:531–5. doi:10.5177/ntvt.2012.11.12232.

    Article  PubMed  Google Scholar 

  4. Matthews L. Scoliosis in children—causes of back pain in kids. http://spinalstenosis.org/blog/scoliosis-children-pain-kids/. Accessed 15 April 2015.

  5. Giampietro PF, Raggio C, Davis JG. Marfan syndrome: orthopedic and genetic review. Curr Opin Pediatr. 2002;14(1):35–41.

    Article  PubMed  Google Scholar 

  6. Shirley ED, Sponseller PD. Marfan syndrome. J Am Acad Orthop Surg. 2009;17:572–81.

    PubMed  Google Scholar 

  7. Milewicz DM, Dietz HC, Miller DC. Treatment of aortic disease in patients with Marfan syndrome. Circulation. 2005;111:e150–7.

    Article  PubMed  Google Scholar 

  8. Lavigne F, Mascard E, Laurian C, Dubousset J, Wicart P. Delayed-iatrogenic injury of the thoracic aorta by an anterior spinal instrumentation. Eur Spine J. 2009;18(Suppl. 2):265–8.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Been HD, Kerkhoffs GM, Balm R. Endovascular graft for late iatrogenic vascular complication after anterior spinal instrumentation: a case report. Spine (Phila Pa 1976). 2006;31:E856–8.

    Article  Google Scholar 

  10. Gjolaj JP, Sponseller PD, Shah SA, Newton PO, Flynn JM, Neubauer PR, Marks MC, Bastrom TP. Spinal deformity correction in Marfan syndrome versus adolescent idiopathic scoliosis: learning from the differences. Spine (Phila Pa 1976). 2012;37:1558–65.

    Article  Google Scholar 

  11. Morrissy RT, Goldsmith GS, Hall EC, Kehl D, Cowie GH. Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error. J Bone Joint Surg Am. 1990;72:320–7.

    CAS  PubMed  Google Scholar 

  12. Sucato DJ, Duchene C. The position of the aorta relative to the spine: a comparison of patients with and without idiopathic scoliosis. J Bone Joint Surg Am. 2003;85-A:1461–9.

    PubMed  Google Scholar 

  13. Sevastik B, Xiong B, Hedlund R, Sevastik J. The position of the aorta in relation to the vertebra in patients with idiopathic thoracic scoliosis. Surg Radiol Anat. 1996;18:51–6.

    Article  CAS  PubMed  Google Scholar 

  14. Liu G, Cheng L, Zhang Y. CT, measurement of the spatial relationship between aorta and neighboring thoracic vertebral body in idiopathic scoliosis. Chin J Med Imaging. 2005;13:206–8.

    Google Scholar 

  15. Zhu F, Chen WJ, Wang WJ, Wang B, Zhu ZZ, Zhu B, Qiu Y. Migration of thoracic aorta after the anterior correction of thoracic idiopathic scoliosis without parietal pleura closure. J Spinal Disord Tech. 2011;24:390–6.

    Article  PubMed  Google Scholar 

  16. Liu J, Shen J, Zhang J, Li S, Zhao H, Qiu G, Wang Y. The position of the aorta relative to the spine for pedicle screw placement in the correction of idiopathic scoliosis. J Spinal Disord Tech. 2012;25:E103–7.

    PubMed  Google Scholar 

  17. Qiu Y, He YX, Wang B, Zhu F, Wang WJ. The anatomical relationship between the aorta and the thoracic vertebral bodies and its importance in the placement of the screw in thoracoscopic correction of scoliosis. Eur Spine J. 2007;16:1367–72.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Lenke LG. Anterior endoscopic discectomy and fusion for adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2003;28(15 Suppl):S36–43.

    Google Scholar 

  19. Glard Y, Launay F, Edgard-Rosa G, Collignon P, Jouve JL, Bollini G. Scoliotic curve patterns in patients with Marfan syndrome. J Child Orthop. 2008;2:211–6.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Bullmann V, Fallenberg EM, Meier N, Fischbach R, Lerner T, Schulte TL, Osada N, Liljenqvist UR. The position of the aorta relative to the spine before and after anterior instrumentation in right thoracic scoliosis. Spine (Phila Pa 1976). 2006;31:1706–13.

    Article  Google Scholar 

  21. Wang W, Zhu Z, Zhu F, Wang B, Chu WC, Cheng JC, Qiu Y. The changes of relative position of the thoracic aorta after anterior or posterior instrumentation of type I Lenke curve in adolescent idiopathic thoracic scoliosis. Eur Spine J. 2008;17:1019–26.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Sucato DJ, Kassab F, Dempsey M. Analysis of screw placement relative to the aorta and spinal canal following anterior instrumentation for thoracic idiopathic scoliosis. Spine (Phila Pa 1976). 2004;29:554–9 (discussion 559).

  23. Bullmann V, Fallenberg EM, Meier N, Fischbach R, Schulte TL, Heindel WL, Liljenqvist UR. Anterior dual rod instrumentation in idiopathic thoracic scoliosis: a computed tomography analysis of screw placement relative to the aorta and the spinal canal. Spine (Phila Pa 1976). 2005;30:2078–83.

    Article  Google Scholar 

  24. Barney L, Freeman III. Chapter 38—Scoliosis and kyphosis. In: Canale ST, Beaty JH, eds. Campbell’s operative orthopaedics, 11th ed. 2007 Mosby, An Imprint of Elsevier. http://www.ckynde.dk/resources/RygStrukturelle.pdf. Accessed 15 April 2015.

  25. Idiopathic scoliosis (2). http://www.scoliosis.cn/dc_content-23224-32951.html. Accessed 15 April 2015.

  26. Kuklo TR, Lehman RA Jr., Lenke LG. Structures at risk following anterior instrumented spinal fusion for thoracic adolescent idiopathic scoliosis. J Spinal Disord Tech. 2005;18:S58–64.

    Article  PubMed  Google Scholar 

  27. Sarlak AY, Tosun B, Atmaca H, Sarisoy HT, Buluç L. Evaluation of thoracic pedicle screw placement in adolescent idiopathic scoliosis. Eur Spine J. 2009;18:1892–7.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Mani K, Rantatalo M, Bjurholm A, Thelin S, Eriksson LG, Wanhainen A. Aortic rupture after spinal correction for scoliosis in the presence of a thoracic stent graft. J Vasc Surg. 2010;52:1653–7.

    Article  PubMed  Google Scholar 

  29. Sokolić J, Sosa T, Ugljen R, Biocina B, Simunić S, Slobodnjak Z. Extrinsic erosion of the descending aorta by a vertebral fixator. Tex Heart Inst J. 1991;18(2):136–9.

    PubMed Central  PubMed  Google Scholar 

  30. Sucato DJ, Elerson E. A comparison between the prone and lateral position for performing a thoracoscopic anterior release and fusion for pediatric spinal deformity. Spine (Phila Pa 1976). 2003;28:2176–80.

    Article  Google Scholar 

  31. Higashino K, Katoh S, Sairyo K, Goda Y, Sakai T, Kitaichi T, Kitagawa T, Yasui N. Pseudoaneurysm of the thoracoabdominal aorta caused by a severe migration of an anterior spinal device. Spine J. 2008;8:696–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Guo-Rong Wang MD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yuan, SM., Wang, GR. Aortic issues in scoliosis and scoliotic operations. Wien Klin Wochenschr 128, 131–136 (2016). https://doi.org/10.1007/s00508-015-0850-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00508-015-0850-3

Keywords

Navigation