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Pedicle screw near the aorta....that can't be good

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  • Pedicle screw near the aorta....that can't be good

    I had a thoracic CT to look for the cause of my L scapular pain and the radiologist noted that a pedicle screw was 9 mm from my aorta. How close is too close? That doesn't sound good to me. Has anyone else had this problem? Help!
    Susan.....too close for comfort
    Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
    2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
    2018: Removal L4,5 screw
    2021: Removal T1 screw & rod

  • #2
    Was it one of the 3d scans. Make sure your surgeon sees it. I have one close also and I have small bone structure and the screw is almost through the bone. We are not doing anything about it though.
    T10-pelvis fusion 12/08
    C5,6,7 fusion 9/10
    T2--T10 fusion 2/11
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16
    Broken neck 9/28/2018
    Emergency surgery posterior fusion C4- T3
    Repeated 11/2018 because rods pulled apart added T2 fusion
    Removal of partial right thoracic hardware 1/2020
    Removal and replacement of C4-T10 hardware with C7 and T 1
    Osteotomy

    Comment


    • #3
      Susan,
      I had a screw at T7 that was 1 mm from the aorta. Dr. Boachie and a top cardiothoracic surgeon agreed it would not cause a problem but it made me extremely nervous. Since I ended up having almost all of my hardware removed due to the P. Acnes infection it is obviously no longer an issue. But, when it was removed there was no sign of damage to the aorta. So, if yours is 9 mm, you are probably safe. Sorry you have yet another thing to worry about, as if we all haven't had enough already! Regards, Lori
      Lori in PA, 52 yrs. old
      T54/L72
      Surgery 6/7/11, T3-S1, all posterior, with pelvic anchors
      Gained 2 inches!
      Dr. Boachie, HSS, NYC
      12/10/13 Hardware Removal for infection
      Lost 2", gained PJK!

      Comment


      • #4
        This is something we see from time to time, and as far as I can remember, no one went to surgery just to remove or revise the screw. If the patient goes to surgery for another spine issue, than removing or revising the screw is reasonable.
        Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
        ---------------------------------------------------------------------------------------------------------------------------------------------------
        Surgery 2/10/93 A/P fusion T4-L3
        Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

        Comment


        • #5
          Thanks Linda and others for your replies. I reviewed the medical literature without finding answers to "safe" distances of screws to the aorta, but did find mention of aneurysms and some screws that caused some bleeding. All were case reports. The above report of Lori's 1 mm distance which was judged OK did give me some confidence that my 9 mm distance is "just fine". Ha! Still nervous.

          I will discuss it with Dr. Hart. Since I have an upcoming revision....lumbar, not thoracic I will see what happens.

          Susan
          Last edited by susancook; 11-10-2015, 06:21 PM.
          Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

          2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
          2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
          2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
          2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
          2018: Removal L4,5 screw
          2021: Removal T1 screw & rod

          Comment


          • #6
            Susan...

            Adding the removal of a single screw to an existing surgery almost certainly adds very little complexity. If you think that knowing the screw is there will bother you (and I totally get why it would), I would ask specifically that it be removed (at least if it's safe to do so).

            --Linda
            Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
            ---------------------------------------------------------------------------------------------------------------------------------------------------
            Surgery 2/10/93 A/P fusion T4-L3
            Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

            Comment

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