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Related Experiment Videos

Spinal pseudarthrosis in ankylosing spondylitis.

F L Chan1, E K Ho, D Fang

  • 1Institute of Radiology and Oncology, University Department of Orthopaedic Surgery, Queen Mary Hospital, Hong Kong.

Acta Radiologica (Stockholm, Sweden : 1987)
|July 1, 1987
PubMed
Summary

Spinal pseudarthrosis, a complication of ankylosing spondylitis, often occurs at interspaces and involves anterior element osteolysis. A posterior element weakness is crucial for its development and progression.

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Area of Science:

  • Orthopedics
  • Rheumatology
  • Spine Surgery

Background:

  • Spinal pseudarthrosis is a significant mechanical complication in patients with long-standing ankylosing spondylitis.
  • This condition can lead to pain, deformity, and neurological deficits.

Purpose of the Study:

  • To investigate the pathogenesis and characteristics of spinal pseudarthrosis in ankylosing spondylitis.
  • To identify key radiological features and contributing factors.

Main Methods:

  • Retrospective analysis of 35 patients with 40 spinal pseudarthrosis lesions.
  • Detailed radiological assessment including plain radiographs and potentially CT scans.
  • Evaluation of lesion location, morphology, and associated spinal abnormalities.

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Main Results:

  • Lesions predominantly occurred at interspaces, particularly in the lower thoracic and upper lumbar spine.
  • Progressive anterior element osteolysis was common, alongside sclerosis, osteophytes, vacuum phenomenon, subluxation, and fragmentation.
  • A posterior element weakness (bony break or facet joint non-fusion) was consistently identified as a critical factor.

Conclusions:

  • Spinal pseudarthrosis in ankylosing spondylitis involves both anterior and posterior spinal elements.
  • Posterior element instability plays a pivotal role in the initiation and progression of the condition.
  • Conservative management is the initial approach, with surgical stabilization required for a significant proportion of patients.