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The position of the aorta relative to the spine in patients with thoracolumbar/lumbar kyphosis secondary to ankylosing spondylitis.
MedLine Citation:
PMID:  23759824     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Study Design. A computed tomography (CT) study.Objective. To explore the anatomic relationship between the aorta and spine in patients with thoracolumbar/lumbar kyphosis secondary to ankylosing spondylitis (AS).Summary of Background Data. The lumbar spinal osteotomy has been widely adopted for the correction of thoracolumbar/lumbar kyphosis caused by AS. During this procedure, the aorta may be stretched at the osteotomized level and in proximity to the tip of the pedicle screw, both of which imply a potential risk of the aortic injury. To date, no reports have been specifically published for describing the position of the aorta relative to the spine in AS patients with fixed thoracolumbar/lumbar kyphosis.Methods. Thirty-three AS patients with thoracolumbar/lumbar kyphosis and thirty-eight age and gender matched patients with a normal spine were included in this study. For each subject, the left pedicle-aorta angle and distance were measured from T9 to L3 on the CT images. Radiographs were analyzed to measure the global kyphosis, lumbar lordosis and to record the apex of the kyphotic curve.Results. At T9-L3 levels, AS patients with thoracolumbar/lumbar kyphosis exhibited significantly smaller Left Pedicle-Aorta angles (from 10.23° to -11.56°) and larger distances (from 39.0 mm to 55.5 mm) than those with a normal spine. With increased global kyphosis, the aorta shifted more laterally to the right at periapical levels (L1 and L2, P <0.05). Notably, the aorta was located at the middle front of the vertebrae at T12-L1 levels, and far away from the vertebrae at L2 and L3 levels.Conclusion. In AS patients with thoracolumbar/lumbar kyphosis, the aorta is positioned more anteromedially relative to the vertebral body compared with that in the normal subjects. The aorta is far away from the vertebral body at L2 and L3 levels, thus it could be much safer to perform osteotomy below L1.
Authors:
Fan Feng; Bang-Ping Qian; Yong Qiu; Bin Wang; Yang Yu; Ze-Zhang Zhu; Jun Jiang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-6-11
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-6-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
The Department of Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
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