The position of the aorta relative to the spine in patients with Pott's thoracolumbar angular kyphosis

Different angular kyphosis locations have different relative positions of aorta to spine in patients with Pott's deformity

Background

The position of the aorta relative to the spine in kyphosis secondary to Pott's deformity is little understood. The purpose of this study was to investigate the anatomic relationship between the aorta and the spine in patients with Pott’s deformity and to compare it with the normal people.

Methods

Seventy-six patients with Pott’s deformity (Group TB) and seventy-two age- and sex-matched patients with a normal spine (group NC) were enrolled in this study. The relative position of aorta to the spine was evaluated from T4 to L4 on the computed tomographic angiography scans for controls and at the apex level for TB patient, and was classified into 4 kinds of degrees.

Results

The left pedicle-aorta angle in group TB was significantly larger than that in group NC at the T6-L3 levels. Group TB exhibited significantly smaller left pedicle-aorta distance, pedicular line-aorta distance and vertebra/rib-aorta distance than those in group NC at the T5-T10 levels, but bigger at the L1-3 levels. Patients with grade 3 and 4 aorta had more segments involved compared with those with grade 1 aorta. Patients with grade 2, 3, and 4 aorta showed larger kyphotic angles than those with grade 1.

Conclusions

Patients whose morbid segments involved only thoracic vertebrae presented with an “Ω” shaped aorta in sagittal plane, and 4 different kinds of degrees of aorta relative to the vertebra/rib in axial plane. Patients whose morbid segments covered lumbar vertebrae presented with an “M” shaped aorta in sagittal plane, and the aorta shifted further from apex vertebra but was located in close proximity to the vertebral body at levels above and below the osteotomy levels in axial plane.

The position of the aorta relative to the spine in patients with adult degenerative scoliosis

Study design

A retrospective analysis was conducted to analyze the position of the aorta by MRI in patients with adult degenerative scoliosis.

Objective

This study aimed to investigate the relative anatomic positions of the aorta and spine in patients with adult degenerative scoliosis (ADS).

Summary of background data

Aorta injury is a rare complication of spinal surgeries. However, there would be a disastrous consequence once it happened. Therefore, knowing about the position of aorta is of great importance.

Methods

A retrospective analysis was performed in 90 patients with ADS and 132 participants without spine deformity. ADS patients were divided into several groups such as left scoliosis, left scoliosis with thoracolumbar kyphosis, right scoliosis, and right scoliosis with thoracolumbar kyphosis. The aorta-vertebrae angle (α) and aorta-vertebrae distance (d) in each level of T12–L4 were measured by using a Cartesian coordinate system. t test of independent samples was performed, α and d were compared, and Pearson correlation analysis was employed for α, d, and X-ray radiographic measurements.

Result

The changes of α were not statistically significant (P > 0.05) in LS and LKS groups but d (P < 0.05) was longer in LKS group compared with the control group. In the right malformed group, there was no significant change in the angle (P > 0.05) in the abdominal aorta but longer d (P < 0.05) than the normal group. There was longer d in the RKS group compared with the RS group (P < 0.05). Pearson correlation analysis showed that there was a positive correlation between d and TLK (r = 0.439, P < 0.05).

Conclusion

In patients with ADS, a relative normal position is maintained between the aorta and vertebrae. While the aorta is slightly away from the left pedicle in RS patients and farther away in patients with kyphosis, the angle of kyphosis would become bigger and d becomes longer. Therefore, the surgeons should be aware of the changes of the aorta position to avoid the disastrous vessel injuries.

Position of the Aorta Relative to Vertebrae in Patients with Degenerative Thoracolumbar or Lumbar Scoliosis: A Case-Control Study

OBJECTIVE

To investigate the position of the aorta relative to the spine in patients with de novo lumbar scoliosis (DLS).

METHODS

This study enrolled 142 patients with DLS, including 80 cases of left thoracolumbar/lumbar scoliosis (left group) and 62 cases of right scoliosis (right group). In addition, 132 cases free of deformity were allocated to the control group. Parameters of the Cobb angle and apical vertebrae were measured by radiograph, whereas the left pedicle-vertebrae angle (α), rotation angle (γ), and left pedicle-vertebrae distance (d) of T12-L4 were obtained by magnetic resonance imaging. Independent sample t test was performed to compare α, γ, and d between the DLS and control groups, followed by a Pearson correlation analysis to study the correlation between Cobb angle and α, γ, and d.

RESULTS

No difference was found between the right group and control group (P = 0.554). The value of mean d (4.62 ± 0.57 cm) gradually increased from T12 to L4 in the left group and showed significant difference with the corresponding value in the control group (4.44 ± 0.43 cm; P < 0.001). There was no significant difference between the right group and control group (P = 0.762). The value of mean d (4.54 ± 1.84 cm) showed no significant difference between the right group and control group (P = 0.530). The correlation analysis showed a significant correlation between rotation angle γ and Cobb angle (P < 0.001), but not in α and d with Cobb angle.

CONCLUSIONS

Although the position of the aorta relative to the spine showed no significant difference between patients with DLS and normal subjects, great attention should still be paid to prevent DLS-induced aorta injury.