胸腰椎移行部前方固定術後に下肢循環が悪化した Leriche's syndrome の一例

抄録

A 72-year-old woman experienced severe left lower extremity pain associated with muscle weakness and sensory disturbance. Rentgenograms of the thoracolumber spine showed old compression fracture of L1. MRI studies showed spinal canal stenosis at L1 upper vertebral level. The patient's symptoms was thought most likely caused by the spinal canal stenosis, we performed anterior spinal instrumentation surgery on the thoracolumbar spine Th12-L2. No problems were encountered during the operation, but her left lower extremity showed cyanosis one day after the operation. Emergency angiography showed chronic occulusion of the terminal abdominal aorta, and she was diagnosed with Leriche's syndrome.
The deterioration was thought to have been segmental arteries approaching to the vertebral body. Since consevative therapy was not effective so axiller-femoral bypass grafting operation was done.