Advertisement

Skeletal Radiology

, Volume 36, Issue 12, pp 1195–1198 | Cite as

Pseudoaneurysm following vertebral biopsy and treatment with percutaneous thrombin injection

  • Keshav Kulkarni
  • Paul Matravers
  • Amrish Mehta
  • Adam Mitchell
Case report

Abstract

We present a case of a pseudoaneurysm within the lumbar musculature. This occurred following a computed tomography (CT)-guided vertebral biopsy in a 79-year-old male patient and was successfully treated with percutaneous ultrasound-guided thrombin injection. The patient initially presented with severe back pain. The plain radiographs and Magnetic resonance imaging (MRI) showed destruction of the L1 and L2 end plates, with marked narrowing of the disc space, suggestive of infective discitis. CT-guided biopsy was performed by the right paravertebral approach. Methicillin-resistant Staphylococcus aureus (MRSA) was grown, following culture of the specimen. Twenty days later, the patient developed a palpable swelling in the right lumbar region, with worsening of the back pain. MRI and ultrasound imaging showed a 3 cm pseudoaneurysm within the right lumbar musculature. The pseudoaneurysm was successfully treated following percutaneous ultrasound-guided injection of thrombin.

Keywords

Spine biopsy Pseudoaneurysm Thrombin 

References

  1. 1.
    Kornblum MB, Wesolowski DP, Fischgrund JS, Herkowitz HN. Computed tomography-guided biopsy of the spine. A review of 103 patients. Spine 1998; 23 1: 81–85.PubMedCrossRefGoogle Scholar
  2. 2.
    Garcés J, Hidalgo G. Lateral access for CT-guided percutaneous biopsy of the lumbar spine. AJR Am J Roentgenol 2000; 174: 425–426.PubMedGoogle Scholar
  3. 3.
    Sucu HK, Cicek C, Rezanko T, et al. Percutaneous computed-tomography-guided biopsy of the spine: 229 procedures. Joint Bone Spine 2006; 73 5: 532–537.PubMedCrossRefGoogle Scholar
  4. 4.
    Brugieres P, Revel MP, Dumas JL, Heran F, Voisin MC, Gaston A. CT-guided vertebral biopsy. A report of 89 cases. J Neuroradiol 1991; 18 4: 351–359.PubMedGoogle Scholar
  5. 5.
    Olscamp A, Rollins J, Tao SS, Ebraheim NA. Complications of CT-guided biopsy of the spine and sacrum. Orthopedics 1997; 20 12: 1149–1152.PubMedGoogle Scholar
  6. 6.
    Lujan S, Puras E, Cancer S, Perera M. Paravertebral pseudoaneurysm thrombosed after percutaneous thrombin injection. Ann Vasc Surg 2005; 19 3: 421–424.PubMedCrossRefGoogle Scholar
  7. 7.
    Ramsay DW, Marshall M. Lumbar artery pseudoaneurysm following renal biopsy: treatment with ultrasound-guided thrombin injection. Australas Radiol 2002; 46 2: 201–203.PubMedCrossRefGoogle Scholar
  8. 8.
    Gray H, Williams PL. Gray’s anatomy: the anatomical basis of medicine and surgery. British edition. 38th edition. Churchill Livingston; 1995. p. 1558.Google Scholar

Copyright information

© ISS 2007

Authors and Affiliations

  • Keshav Kulkarni
    • 1
  • Paul Matravers
    • 1
  • Amrish Mehta
    • 1
  • Adam Mitchell
    • 1
  1. 1.The Hammersmith Hospitals NHS TrustLondonUK

Personalised recommendations