Fractures and Dislocations of the Spine Complicating Ankylosing Spondylitis

Grisolia, Andres; Bell, Robert L.; Peltier, Leonard F.

doi:10.2106/00004623-196749020-00012

Cited by 87 publications

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“…Of the six cases with congenital fusion, three injuries were caused by Many authors have reported the phenomenon of rapid bony consolidation of injuries to the ankylosed cervical spine. They include Ackerman (1972), Bergmann (1949), Cheshire (1969), Good (1967), Grisolia et al (1967) and Rand and Stern (1961). Our experience (Table IV) substantiates their observations.…”

Section: Mechanism Of Injurysupporting

confidence: 86%

“…The experience gained from this series of cases compels us to join with other authors in stressing the need for a high index of diagnostic suspicion in instances of even minor head and neck trauma in persons with ankylosed spines, particularly those who have ankylosing spondylitis (Grisolia et at., 1967;Hansen et at., 1967;Woodruff & Dewing, 1963). Many of our cases and the cases reported by others have occurred as a result of minor injuries, particularly falls.…”

Section: Clinical Management-diagnosismentioning

confidence: 85%

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Cervical ankylosis with acute spinal cord injury

et al. 1977

Spinal Cord

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Abstract.Twenty-three cases of acute spinal cord injury in persons with cervical ankylosis are presented. Certain characteristics of major sub-groups are described:ankylosing spondylitis (N = 8), degenerative spondylosis (N = 9) and congenital fusion (congenital non-segmentation) (N = 6). The ankylosing spondylitic group presented a grim prognosis for survival (death rate 50 per cent within 60 days) and for loss of neuro logical function. Five out of eight cases had permanent neurological loss subsequent to their injuries.Both the ankylosing spondylitic and degenerative spondylotic groups presented problems in diagnosis and medical management. The basic principle is immobilisation of the fracture and mobilisation of the patient. The halo is the technique of choice for fracture immobilisation. An integrated intensive respiratory management programme is essential. Patients with ankylosed spines, particularly those with ankylosing spondylitis, should be educated in simple measures to prevent fracture of their spines.

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Section: Mechanism Of Injurysupporting

confidence: 86%

Section: Clinical Management-diagnosismentioning

confidence: 85%

Cervical ankylosis with acute spinal cord injury

et al. 1977

Spinal Cord

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“…11 Multiple non-contiguous vertebral fractures have been well recognized in ankylosing spondylitis. 12,13 This incidence in the normal spine is reported to be from 4 ± 8%. 14 Their incidence is unknown in the ankylosing spondylitis population.…”

Section: Discussionmentioning

confidence: 97%

Occult vertebral fractures in ankylosing spondylitis

1999

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Study Design: A retrospective review of patients with ankylosing spondylitis involved in blunt trauma. Setting: Patients referred to two Level I trauma centers. Objectives: To determine the incidence and clinical sequelae in this patient population where vertebral injury was diagnosed on a delayed basis. Summary of Background Data: The ankylosed spine is at increased risk for fracture and spinal cord injury. Radiological identi®cation of injury is more di cult than in the normal spine. Results: Over a 5 year period, 21 patients were identi®ed with seven having an occult vertebral fracture not recognized as the primary injury or occurring as a second noncontiguous injury level. In these cases, delay in diagnosis of the occult injury was from 3 to 22 days. Development of secondary neurological de®cits occurred in three patients. Conclusions: A high index of suspicion and an appreciation of the extreme instability of a fracture in ankylosing spondylitis must be present.

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“…Weinstein et al (1982) noted that some of their AS patients fell because they could not see the ground ahead while walking, due to progressive dorsal kyphosis, and they proposed that such patients should be counselled to exercise caution during ambulation. Grisolia et al (1967), Murray and Persellin (1981), Rand andStern (1961), andWoodruff andDewing (1963) all reported a history of alcoholic intoxication in some of their AS patients who sustained a spinal cord lesion after a fall. In five of our patients there was also a history of alcoholic use which was probably a contributory factor in their injury.…”

Section: Discussionmentioning

confidence: 99%

“…It is typically seen in the young patient without vertebral damage or in the older individual who has arthritic changes of the spine (Foo and Rossier, 1982), especially in the patient with AS (Bohlman, 1979;Farhatet al, 1973;Grisolia et al, 1967). In their review of the literature Hunter and Dubo (1983) noted that there was evidence of spinal epidural bleeding in nine out of 54 (16.7°0) AS patients who had spinal fractures.…”

Section: Discussionmentioning

confidence: 99%

Cervical spinal cord injury complicating ankylosing spondylitis

1985

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SummaryWithin a period of 12 years 466 patients with acute spinal cord injury were admitted to our Centre, seven of these having ankylosing spondylitis (AS), A history of alcohol consumption preceding the accident was present in five patients, and in four there was a history of neurological deterioration before their admission. An epidural hematoma was found in one patient and four expired within 3 months of their injury,The incidence of ankylosing spondylitis in cervical cord injury was 1.5°,,, and an associated epidural hematoma was present in some 14% of the patients, The mortality rate was 57%, There was a high incidence of alcoholic use before the accident. Neurological deterioration commonly occurred before admission,

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Fractures and Dislocations of the Spine Complicating Ankylosing Spondylitis

Cited by 87 publications

References 0 publications

Cervical ankylosis with acute spinal cord injury

Cervical ankylosis with acute spinal cord injury

Occult vertebral fractures in ankylosing spondylitis

Cervical spinal cord injury complicating ankylosing spondylitis

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