Comparison of Outcomes in Percutaneous Fixation of Traumatic Fractures between Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis

Abstract

Study Design Retrospective cohort study. Objectives This study aims to analyze outcomes and complications of patients with thoracic and lumbar fractures in the setting of ankylosing spinal disorders (ASD) treated with minimally invasive surgery (MIS). Methods The operative logs from 2012 to 2019 from one academic, Level I trauma center were reviewed for cases of thoracic and lumbar spinal fractures in patients with ASD treated with a MIS approach. Variables were compared between patients with ankylosing spondylitis (AS), diffuse idiopathic skeletal hyperostosis (DISH), and advanced spondylosis. Results A total of 48 patients with ASD and concomitant thoracic or lumbar spinal fracture managed with an MIS approach were identified. A total of 11 patients were identified with AS, 21 with DISH, and 16 with advanced spondylosis. A total of 27 (56.3%) patients experienced complications. Complications differed between groups; DISH patients experienced a greater number of post-operative complications compared to AS and advanced spondylosis patients ( P = .009). There was no significant difference in length of surgery, estimated blood loss, length of stay, readmission, and reoperation rates between AS and DISH patients. There were 3 mortalities unrelated to the surgery. Conclusion Percutaneous stabilization of patients with ankylosing spinal disorder fractures remains a viable management method. Operative characteristics were similar between AS, DISH, and advanced spondylosis patients; however, DISH patients experienced a greater number of post-operative complications.

Surgical outcomes of robotic-assisted percutaneous fixation for thoracolumbar fractures in patients with ankylosing spondylitis

“…In recent years, minimally invasive surgery has been recognized by the majority of doctors, especially for elderly AS patients with more underlying diseases. It can achieve better clinical results and reduce the occurrence of surgical complications [ 9 , 10 , 29 , 30 ]. Ye et al [ 9 ] demonstrated that minimally invasive surgery can achieve effects similar to those of traditional open surgery, while reducing bleeding, trauma, and postoperative complications.…”

Prognostic factors of balloon kyphoplasty for osteoporotic vertebral fractures with diffuse idiopathic skeletal hyperostosis

“…10 Fusion surgery for OVFs in ankylosing spines with DISH has been previously reported; [11][12][13][14] however, minimally invasive treatment is desirable due to the high incidence of postoperative complications reported in patients with DISH. 15,16 Although the treatment of ankylosing spinal fractures requires fusion surgery similar to that required for long bone fractures, the indications for BKP in fractures of the terminal or adjacent vertebral bodies of ankylosing spines remain controversial. 9,17 Therefore, the purpose of this study was to determine the poor prognostic factors of BKP for the treatment of fractures of the most distal or distal-adjacent vertebrae of ankylosing spines with DISH.…”