Circumferential Fusion through All-Posterior Approach in Andersson Lesion

Area of Science:

• Spine surgery
• Orthopedics
• Spinal fusion

Background:

• Andersson lesions (AL) in ankylosing spondylitis can lead to progressive kyphosis and neurological deficits.
• Surgical stabilization is indicated for unstable AL, but the role of anterior reconstruction remains unclear.

Purpose of the Study:

• To evaluate the safety and efficacy of a single-stage posterior stabilization with anterior cage reconstruction for Andersson lesions.
• To assess outcomes using transforaminal or lateral extra-cavity approaches.

Main Methods:

• Retrospective case series of 20 consecutive patients with unstable Andersson lesions.
• Single-stage posterior approach with long-segment pedicle screw fixation and anterior vertebral reconstruction.
• Radiological (kyphotic angle, CT, MRI) and functional (VAS, ASQoL, ODI) outcome assessments.

Main Results:

• Mean follow-up of 2.1 years. Significant improvements in VAS (8.2 to 2.4), ODI (62.7 to 18.5), and ASQoL (14.3 to 7.9) (p <0.05).
• All patients achieved radiological union by a mean of 7.2 months. Mean kyphotic angle improved from 27° preoperatively to 18.1° at final follow-up.
• Mean surgical duration: 112 minutes; blood loss: 452 mL; hospital stay: 6.2 days.

Conclusions:

• An all-posterior approach for posterior stabilization and anterior cage reconstruction is safe and effective for Andersson lesions.
• This technique leads to good radiological and functional outcomes, including pain reduction and improved quality of life.