Complications of the spine in ankylosing spondylitis with a focus on deformity correction

Mundwiler, Matthew L; Siddique, Khawar; Dym, Jeffrey M; Perri, Brian; Johnson, J. Patrick; Weisman, Michael H.

doi:10.3171/foc/2008/24/1/e6

Cited by 45 publications

(38 citation statements)

References 52 publications

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“…The reported prevalence of vertebral fractures varies widely (10-17%) and the incidence of neurologic complications is very high (29-91%) [7,8]. The exact prevalence of AL complicating AS in literature is unknown, but reported prevalence ranges from 1.5% to over 28% [1][2][3][4][5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…The exact prevalence of AL complicating AS in literature is unknown, but reported prevalence ranges from 1.5% to over 28% [1][2][3][4][5][6][7][8]. This large variation is because of the lack of proper diagnostic criteria and the differences in the extent of spinal survey undertaken.…”

Section: Discussionmentioning

confidence: 99%

“…These include repetitive stress on skipped segments that have not completely ossified [2], a biomechanically weak hyperkyphotic spine [2,6,7,12], trauma [3][4][5][6], and progressive inflammation too [1]. It is worthwhile noting that inflammatory lesions usually affect multiple levels during the early part of AS.…”

Section: Discussionmentioning

confidence: 99%

“…Surgery for unstable fractures in AS includes anterior/posterior decompression and fixation or both. Decompression, instrumentation, bone grafting, and various osteotomies for deformity correction have been reported and long segment fixation is usually preferred for fractures [1,3,[6][7][8], but surgical recommendations for AL are scarce.…”

Section: Introductionmentioning

confidence: 99%

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Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

2011

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This study reviews the presentation, etiology, imaging characteristics and reasons for missed diagnosis of Andersson lesion (AL) and analyzes the surgical results of short segment fixation in the thoracolumbar region. This is a retrospective single center study. Fourteen patients (15 lesions) who were operated for AL were analyzed. The study was designed in two parts. The first part consisted of analysis of clinical and radiological features (MRI and radiographs) to highlight, whether definitive characteristics exist. The second part consisted of analysis of outcome of short segment fixation as measured by VAS, Frankel score, AsQoL index, and union, with assessment of complications. The follow-up was 42.33 ± 19.29 months (13 males and 1 female) with a mean age of 61.13 ± 19.74 years. There was predisposing trauma in five patients. There was a delay in presentation of the patients by 5.86 ± 2.50 months. There was misdiagnosis in all the cases, at primary orthopedic level (ten cases were put on anti-tuberculous treatment due to its MRI resemblance to infection) and all but one case at radiologist level. Radiographs and MRI had characteristic features in all cases, and MRI could detect posterior element affection in 14 lesions as against only 8 posterior lesions detected in radiographs. In all patients, there was a patient's delay and/or physician's delay to arrive at a diagnosis. Spinal fusion was seen in all the cases. Outcome measures of VAS, Frankel score, and AsQoL index showed significant improvement (P \ 0.002). No major complications occurred. There is a lack of awareness of AL leading to misdiagnosis. Definite clinico-radiological features do exist in AL and short segment fixation is effective.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

2011

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“…When fractures do occur, there is a much higher incidence of neurological deficit in patients with ankylosing spondylitis than in the general population. 25 The consequences of ankylosing spondylitis with regard to the atlantoaxial complex are less well described. Overall, the reported incidence of atlantoaxial subluxation in patients with ankylosing spondylitis is 0.5%-35%.…”

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confidence: 99%

Ankylosing spondylitis of the craniovertebral junction: a single surgeon's experience

Albert¹,

Menezes²

2011

SPI

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Object The objective of this study was to describe a single surgeon's experience managing craniovertebral junction (CVJ) disease due to ankylosing spondylitis. Methods The authors undertook a retrospective review of the records of patients with CVJ disease due to ankylosing spondylitis who were evaluated and treated by the senior author. Charts were reviewed for symptoms and signs at presentation, radiography results, treatment, and outcome. In addition, some of the patients had pathology reports available for review. Results Eight patients with CVJ disease due to ankylosing spondylitis were identified who were evaluated by the senior author in the years 1990–2008. The most common presenting symptoms were neck pain (37.5%), cranial neuropathy (37.5%), and sensory disturbance (62.5%). On examination, the most common findings were limited cervical range of motion (37.5%), weakness (50%), and myelopathy (75%). Radiographic evaluation revealed atlantoaxial subluxation, retroodontoid pannus formation, basilar invagination, and bone erosion. Surgery was offered to all of the patients, 7 of whom underwent operations. In most cases, the treatment was transoral–transpalatopharyngeal decompression followed by occipitocervical fusion. One patient with a reducible lesion underwent dorsal fusion alone. Neurological outcomes were favorable overall. Conclusions The incidence of CVJ disease in patients with ankylosing spondylitis varies among reports. These cases are rare in most neurosurgery clinics. It is important to recognize that patients with ankylosing spondylitis are at risk for CVJ disease, similar to patients with rheumatoid arthritis. Principles common to the management of other CVJ pathologies apply to these patients as well.

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Seronegative Spondyloarthropathies

Snyder

2021

Clinical Foundations of Musculoskeletal Medicine

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Complications of the spine in ankylosing spondylitis with a focus on deformity correction

Cited by 45 publications

References 52 publications

Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

Ankylosing spondylitis of the craniovertebral junction: a single surgeon's experience

Seronegative Spondyloarthropathies

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