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A 73-year-old man complained of severe back pain and increased difficulty in walking. A contrast-enhanced computed tomography(CT)scan revealed a lobular dilatation of the abdominal aorta, which had eroded into the anterior part of the adjacent vertebral bodies at T12 and L1. T1-weighted magnetic resonance(MR)images revealed a hypointense signal at the T12/L1 level. The diagnosis was pyogenic vertebral osteomyelitis of the thoracolumbar spine associated with an infected abdominal aortic aneurysm. Following antibiotic therapy for several weeks, the patient underwent aortic stenting and bypass surgery with an artificial graft for the visceral branches. After vascular surgery, the aortic aneurysm disappeared on the contrast-enhanced CT scans. Although the infection had resolved, the patient’s back pain persisted because of osteolytic changes in the T12 and L1 vertebral bodies. Thereafter, he was transferred to our spinal surgery unit. We performed anterior reconstruction of the thoracolumbar spine and one-stage posterior spinal fixation. The necrotic disc and the adjacent infected vertebrae were exposed via an extrapleural approach and were excised subtotally. Two fibular bone grafts were used to reconstruct the spinal column. Posterior spinal fixation was performed from T10 to L3 using the cortical bone trajectory technique. Postoperatively, the patient experienced a significant reduction in pain and no perioperative complications were noted. Coexistence of pyogenic vertebral spondylitis and an infected abdominal aortic aneurysm is rare;however, this condition could be life threatening if not treated effectively, and warrants appropriate diagnosis by the spinal surgeons in order to ensure adequate management. (Received:Nobember 14, 2012;accepted:April 1, 2013)

Pyogenic Vertebral Osteomyelitis of the Thoracolumbar Spine Associated with an Infected Abdominal Aortic Aneurysm—A Case Report—