Concomitant cervical and thoracic spinal fractures in ankylosing spondylitis: A case report and review of literature

Anwar, Fahim; Khayer, Ahmad Al; Fraser, Matthew; Allan, D.B.

doi:10.1016/j.injury.2009.06.169

Cited by 8 publications

(7 citation statements)

References 18 publications

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“…This patient underwent emergent posterior lumbar decompression and instrumented fusion from L2 to S2. c Postoperative lateral radiograph and d sagittal threedimensional volume-rendered CT image showing the instrumentation construct and the persistent fracture gap (arrow in a and b) these conditions [72]. However, some authors [6,23] suggest to consider treatment with biphosphonates in patients with clinical or morphometric vertebral fractures.…”

Section: Treatmentmentioning

confidence: 99%

“…Failure with anterior or posterior stabilization alone suggested that combined anterior and posterior fixation would be the preference in the fixation of these highly unstable fractures, as it has resulted in no failure [41,47,81,97]. Definitive fracture fixation has many advantages over non-operative approach, such as excellent deformity correction, immediate stability, direct and indirect decompression of the spinal canal, early mobilization, and prevention of secondary neurological complications [72,98]. The disadvantages of surgical intervention include postoperative complications, particularly respiratory, and increased mortality [72].…”

Section: Treatmentmentioning

confidence: 99%

“…Definitive fracture fixation has many advantages over non-operative approach, such as excellent deformity correction, immediate stability, direct and indirect decompression of the spinal canal, early mobilization, and prevention of secondary neurological complications [72,98]. The disadvantages of surgical intervention include postoperative complications, particularly respiratory, and increased mortality [72]. Comorbidities associated with AS increase the incidence of postoperative complications, and the risk of poor outcome with surgery increases with age [72].…”

Section: Treatmentmentioning

confidence: 99%

“…The disadvantages of surgical intervention include postoperative complications, particularly respiratory, and increased mortality [72]. Comorbidities associated with AS increase the incidence of postoperative complications, and the risk of poor outcome with surgery increases with age [72]. It has been shown that percutaneous instrumentation limits the invasiveness of the surgical approach, thereby diminishing the risk of bleeding and infection due to muscle dissection [89,99].…”

Section: Treatmentmentioning

confidence: 99%

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Spinal fractures in patients with ankylosing spondylitis

Leone¹,

Marino²,

Dell'atti³

et al. 2016

Rheumatol Int

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The ankylosed spine is prone to fracture even after minor trauma due to its changed biomechanical properties. The two central features of ankylosing spondylitis (AS) that promote the pathological remodeling of the spine are inflammation and new bone formation. AS is also associated with osteoporosis that is attributed to an uncoupling of the bone formation and bone resorption processes. Therefore, bone resorption occurs and promotes weakening of the spine as well as increased risk of vertebral fractures which can be hugely different in terms of clinical relevance. Even in the presence of symptomatic clinical vertebral fractures, the diagnosis can be overruled by attributing the pain to disease activity. Furthermore, given the highly abnormal structure of the spine, vertebral fracture diagnosis can be difficult on the basis of radiography alone. CT can show the fractures in detail. Magnetic resonance imaging is considered the method of choice for the imaging of spinal cord injuries, and a reasonable option for exclusion of occult fractures undetected by CT. Since it is equally important for radiologists and clinicians to have a common knowledge base rather than a compartmentalized view, the aim of this review article was to provide the required clinical knowledge that radiologists need to know and the relevant radiological semiotics that clinicians require in diagnosing clinically significant injury to the ankylosed spine.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Spinal fractures in patients with ankylosing spondylitis

Leone¹,

Marino²,

Dell'atti³

et al. 2016

Rheumatol Int

View full text Add to dashboard Cite

show abstract

“…Комментарии [1,[57][58][59][60][61][62][63][64] К сожалению, в настоящее время еще нет четких рекомендаций, когда, кому, почему и в каком объеме проводить хирургическое вмешательство при АС. Однако уже очерчены некоторые проблемы, связанные в том числе и с этим заболеванием.…”

Section: хирургическая помощь при анкилозирующем спондилитеunclassified

The Basic Principles of Treatment of Ankylosing Spondylitis (Bechterew's Disease)

Erdes¹

2014

rsp

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Delayed presentation and diagnosis of cervical spine injuries in long-standing ankylosing spondylitis

et al. 2010

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Patients with ankylosing spondylitis (AS) are vulnerable to cervical spine fractures. Long-standing pain may mask the symptoms of the fracture. Radiological imaging of the cervical spine may fail to identify the fracture due to the distorted anatomy, ossified ligaments and artefacts leading to delay in diagnosis and increased risk of neurological complications. The objectives are to identify the incidence and risk factors for delay in presentation of cervical spine fractures in patients with AS. Retrospective case series study of all patients with AS and cervical spine fracture admitted over a 12-year period at Queen Elizabeth National Spinal Injuries Unit, Scotland. Results show that total of 32 patients reviewed with AS and cervical spine fractures. In 19 patients (59.4%), a fracture was not identified on plain radiographs. Only five patients (15.6%) presented immediately after the injury. Of the 15 patients (46.9%) who were initially neurologically intact, three patients had neurological deterioration before admission. Cervical spine fractures in patients with long-standing AS are common and usually under evaluated. Early diagnosis with appropriate radiological investigations may prevent the possible long-term neurological cord damage.

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Concomitant cervical and thoracic spinal fractures in ankylosing spondylitis: A case report and review of literature

Cited by 8 publications

References 18 publications

Spinal fractures in patients with ankylosing spondylitis

Spinal fractures in patients with ankylosing spondylitis

The Basic Principles of Treatment of Ankylosing Spondylitis (Bechterew's Disease)

Delayed presentation and diagnosis of cervical spine injuries in long-standing ankylosing spondylitis

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