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

  1. #1
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,527

    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 Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision 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 + prayer

  2. #2
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    766
    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
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    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

  3. #3
    Join Date
    Apr 2010
    Location
    Easton PA
    Posts
    182
    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!

  4. #4
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,802
    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. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  5. #5
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,527
    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 at 07:21 PM.
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision 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 + prayer

  6. #6
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,802
    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. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

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