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Multiple and simultaneous spine fractures in ankylosing spondylitis: case report
Dino Samartzis1, D Greg Anderson, Francis H Shen
1Division of Health Sciences, University of Oxford, Oxford, United Kingdom.
Spine
|December 2, 2005
Summary
Patients with ankylosing spondylitis are highly susceptible to spine fractures from minor trauma. This case highlights the risk of multiple, simultaneous fractures, especially with prior spinal instrumentation, necessitating thorough evaluation and careful management.
Area of Science:
- Spine surgery
- Orthopedics
- Traumatology
Background:
- Ankylosing spondylitis increases spine fracture risk.
- Multiple simultaneous spine fractures are rare in ankylosing spondylitis.
- The role of spinal instrumentation in fracture development is not well-documented.
Observation:
- An 81-year-old male with ankylosing spondylitis experienced two falls resulting in three spine fractures.
- The patient had prior multilevel spine instrumentation.
- Fractures occurred at T11-T12, C6-C7, and L2-L3 levels, with one associated spinal cord injury.
Findings:
- Anatomic reduction and stable fixation were achieved for all fractures.
- Neurologic status did not improve after the second injury.
- Postoperative pulmonary failure led to death within three months.
Implications:
- Ankylosing spondylitis patients are prone to severe fractures from minor trauma.
- Thorough spinal imaging and careful surgical planning are crucial.
- Preexisting spinal instrumentation may increase the risk of subsequent fractures.
