A 45-year-old man sustained spinal fractures (T6-T8 vertebrae) in a road traffic accident, and underwent pedicle screw fixation of the vertebrae. On the 2nd postoperative day, he developed retrosternal discomfort with dyspnea. Computed tomography-aortography showed the pedicle screw at T6 level extending into the prevertebral region and piercing the posterior wall of the aorta, and the screw at T8 level compressing the medial wall of the aorta without perforation (Figures 1 and 2). No active contrast leak was noticed. Via a left posterolateral thoracotomy, the tip of one screw was seen piercing the adventitia and media but not entering the lumen. The pedicle screws were removed, and the tiny aortic defect was closed with pledgetted 4/0 Prolene sutures. The patient was stable postoperatively and was discharged on the 7th postoperative day.
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