• Tetsuya Shimokawa, Kei Miyamoto, Akira Hioki, Takahiro Masuda, Haruhiko Akiyama, and Katsuji Shimizu.
• *Department of Orthopaedic Surgery, School of Medicine, Gifu University, Gifu, Japan †Department of Reconstructive Surgery for Spine, Bone, and Joint, Gifu University Graduate School of Medicine, Gifu, Japan; and ‡Spine Center, Gifu Municipal Hospital, Gifu, Japan.
• Spine. 2014 May 1; 39 (10): E657-9.

Study DesignA case report and review of the literature.ObjectiveTo discuss the significance of identifying trachea-thoracic vertebral body fistula.Summary Of Background DataSeveral authors have reported the occurrence of communication between the trachea and the spinal canal or paraspinal abscess. However, trachea-thoracic vertebral body fistulas have not been reported.MethodsA 77-year-old male experienced gradually worsening lower-extremity palsy. Fifteen years before presentation, he had undergone retrosternal esophageal reconstruction with a gastric tube for esophageal cancer.ResultsComputed tomographic scan revealed compression of the Th5 vertebral body; the trachea and the Th5 vertebral body were connected by a fistula, and air seemed to enter Th5 from the trachea. Magnetic resonance image showed severe spinal canal stenosis. Posterior thoracic decompression and fusion was performed. Five months after the procedure, he regained the ability to walk with a cane, and computed tomographic scan revealed closure of the fistula and the bony fusion.ConclusionTo our knowledge, this is the first case report of a trachea-thoracic vertebral body fistula. Because the trachea is adjacent to the anterior aspect of the thoracic vertebrae, in cases of retrosternal esophageal reconstruction, trachea-vertebral body fistula should be a differential diagnosis for destructive changes in thoracic vertebrae without any signs of trauma.

25 keywords...

hide…