Renal artery thrombosis is associated with a fracture at which vertebral level?

• A. L1
• B. L2
• C. L3
• D. L4

Answer: (B)

Renal artery thrombosis relates to where the renal arteries originate from the aorta. The renal arteries arise from the abdominal aorta at about the level of the second lumbar vertebra. Because the vessels are fixed where they branch from the aorta and then course toward the kidneys, a fracture at that vertebral level can directly injure the renal artery or its origin, promoting thrombosis and reduced renal blood flow. The kidneys sit retroperitoneally near the lower thoracic to upper lumbar spine, so the level of the second lumbar vertebra is the one most closely associated with the renal vessels.