Thoracolumbar Fractures in Ankylosing Spondylitis High-Risk Injuries

G, Trent; Gw, Armstrong; O’Neil, Joseph T.

doi:10.1097/00003086-198802000-00009

Cited by 65 publications

(43 citation statements)

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“…In the former, six of seven cases had diagnoses missed on initial examination and two of these developed a complete paraplegia. 9 In the latter series, four of ®ve patients had delayed diagnoses with resulting neurologic sequelae in three. This series included a simultaneous non-contiguous occult fracture at C6 ± 7 which went on to displace causing a complete paraplegia.…”

Section: Discussionmentioning

confidence: 92%

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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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Section: Discussionmentioning

confidence: 92%

“…There is a risk however with moving an unstable spine several times. Trent et al 9 note the possibility in displacing a fracture by placing the patient in the lateral or a supine position when a preexisting kyphosis exists. Bone scan is also useful in detecting a suspected acute fracture.…”

Section: Discussionmentioning

confidence: 99%

Occult vertebral fractures in ankylosing spondylitis

1999

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“…In addition, AS is also associated with vertebral osteoporosis [18]. Therefore, AS patients in advanced stage are more susceptible to fracture due to the rigidity of the ossified spine and osteoporosis [18,19,22]. A stress fracture is most likely to occur in thoracolumbar junction, a region with tremendous stress forces concentrated [4].…”

Section: Introductionmentioning

confidence: 99%

Pedicle subtraction osteotomy through pseudarthrosis to correct thoracolumbar kyphotic deformity in advanced ankylosing spondylitis

et al. 2011

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“…It is not an exaggeration to say, that new back pain in patients with ankylosing spondylitis should be assumed to be caused by a fracture until proven otherwise (Einsiedel et al, 2006;Hanson and Mirza, 2000;Trent et al, 1988). Thus, thorough clinical and radiological assessment should be performed in these patients and should be repeated for the first few weeks, especially if the patient complains for indefinable pain or if neurological disorders are noted.…”

Section: Diagnostic Approach and Clinical / Radiological Findingsmentioning

confidence: 99%

“…The diffuse paraspinal ossification and inflammatory osteitis of advanced AS creates a fused, brittle spine that is susceptible to fracture (De Peretti et al, 2004;Einsiedel et al, 2006;Hanson and Mirza, 2000;van der Horst-Bruinsma, 2006;Taggard ans Traynelis, 2000;). Patients suffering from AS may undergo a fracture with minimal (Graham and Van Peteghem, 1989;Hanson and Mirza, 2000;Trent et al, 1988;Whang et al, 2009), or even no history of injury (Olerud et al, 1996;Westerveld et al, 2009;Yau and Chan, 1974).…”

Section: Introductionmentioning

confidence: 99%