Aortic injury in spine surgery……What a spine surgeon needs to know

Safwan Alomari, Ryan Planchard, Sheng Fu Larry Lo, Timothy Witham, Ali Bydon

Research output: Contribution to journalReview articlepeer-review


Aortic injury is a rare, yet underreported and underestimated complication of spine surgery. Anatomical relation between the aorta and the spine changes under physiological (positional) as well as pathological (deformity) conditions, which puts the aorta at risk of injury during spine surgery. Clinical presentation of aortic injury ranges from asymptomatic perforation of the aorta to acute fatal bleeding. Although several diagnostic methods have been reported, CT-angiography remains an important diagnostic study. Several advancements in the open and the endovascular surgical management have been reported to be successfully used in the management of aortic injury following spine surgery. Management approach of malpositioned screws abutting the aorta is still controversial. Anatomical knowledge and understanding of the previously reported mechanisms of aortic injury are important to be integrated in the preoperative planning process. If the complication occurs, time-to- recognition and to-appropriate-management are important factors for predicting mortality. If unrecognized and untreated in the acutely injured patients, mortality can approach 100%.

Original languageEnglish (US)
Pages (from-to)3189-3196
Number of pages8
JournalNeurosurgical Review
Issue number6
StatePublished - Dec 2021


  • Aortic injury
  • Malpositioned screws
  • Postoperative imaging
  • Spine surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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