Abstract
A 20-year-old man, known to have systemic lupus erythematosus, presented with a year-long history of thoracolumbar backache. He made intermittent use of simple analgesics, and had received steroid therapy over five years from the age of 13. Clinical examination revealed a mild right thoracic rib hump. Plain radiographs and CT scan showed a thoracic aortic aneurysm with an estimated 50% loss of the left anterolateral part of vertebral bodies T7, T8 and T9.
The patient required resection of the aneurysm and replacement graft. An orthopaedic opinion was requested about the possible need for simultaneous spinal stabilisation surgery. The vertebral bone loss was considered similar to the bone loss seen in bullet injuries of the spine, and therefore unlikely to result in spinal instability. This proved to be the case in follow-up radiological examination at 16 months.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at The Department of Orthopaedic Surgery, Medical School, University of Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa
