Ankylosing spondylitis confers substantially increased risk of clinical spine fractures: a nationwide case-control study

Abstract

Patients with AS have a 5-fold higher risk of clinical spine fracture and a 35% increased risk of non-vertebral fracture. This excess risk peaks early, in the first 2.5 years of AS disease. Patients should be assessed for fracture risk early after AS diagnosis.

Etanercept Increases Bone Mineral Density in Ankylosing Spondylitis, but Does Not Prevent Vertebral Fractures: Results of a Prospective Observational Cohort Study

“…Bone loss is highly prevalent after long disease duration, but starts at an early stage 3,4 . Bone loss and inflammation are probably responsible for the occurrence of vertebral fractures (VFx) in this patient group 5,6,7,8 . The pathogenesis of the decrease in bone mineral density (BMD) is complex.…”

MANAGEMENT OF ENDOCRINE DISEASE: Secondary osteoporosis: pathophysiology and management

“…Osteoporosis is seen in up to 25%, and osteopenia in up to 50%, of patients with AS with a higher incidence of both vertebral and non-vertebral fractures (214) . The etiology of osteoporosis in patients with AS is multifactorial with systemic inflammation mediated by TNF-α being the most important etiologic factor.…”

Adult vertebral fractures

“…It has been suggested this group are up to five times more likely to sustain a spinal fracture than the normal population. 12 Due to their kyphosis these patients often have as their normal shape cervical blocks and collars may often not be suitable for use in suspected C-spine trauma. The patient's head and neck should be positioned the in their normal position (Figure 15).…”