Background: The coexistence of an unstable spinal fracture with a pending aortic lesion is potentially catastrophic and a therapeutic challenge as to timing of treatment, assigning priorities and selecting the best approach.
Case report: A 41 year-old healthy male victim of bike accident. Imaging revealed a fracture of 6th and 7th thoracic vertebrae with a bone fragment in close proximity to the descending thoracic aorta. After consultation with spine/vascular surgeons and interventional radiologists it was decided to secure the potential aortic injury with an endovascular stent-graft followed by posterior vertebral instrumentation for fracture's reduction.
Discussion/conclusion: A multi-specialists teamwork approach is mandatory. Vascular lesion is priority, followed by vertebral surgery. As to the treatment options, we suggest a "best but still safest" philosophy: endovascular repair and posterior spinal instrumentation should be considered first in the acute stage.
Keywords: Aorta; Case report; Endovascular procedure; Fracture fixation; Spinal injury; Trauma center; Trauma team.
Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.