Related Experiment Video
Updated: Oct 19, 2025
04:19
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
663
Quiescent Andersson Lesion Simplifies Deformity Correction: A Case Report
Arvind G Kulkarni1,2, Goparaju V N R Praveen1,2
1Mumbai Spine Scoliosis and Disc Replacement Centre, Mumbai, India.
JBJS Case Connector
|September 24, 2021
Summary
This case study highlights how a suspicious Andersson lesion (AL) in ankylosing spondylitis can unexpectedly change during surgery. Intraoperative reassessment led to a successful fusion without osteotomy.
Area of Science:
- Spine surgery
- Rheumatology
- Radiology
Background:
- Ankylosing spondylitis (AS) can lead to spinal deformities like sagittal imbalance.
- Andersson lesions (AL) are inflammatory lesions at the discovertebral junction, often seen in AS.
- Preoperative imaging may not always reveal the dynamic instability of ALs.
Observation:
- A patient with AS and sagittal imbalance presented with a suspicious D12-L1 Andersson lesion (AL).
- Initial imaging (radiographs and MRI) suggested no significant mobility at the AL segment.
- A planned L2 pedicle subtraction osteotomy was reconsidered due to intraoperative findings.
Findings:
- The Andersson lesion (AL) significantly destabilized during intraoperative positioning, contrary to preoperative assessments.
- The surgical plan was adapted intraoperatively, shifting from osteotomy to interbody fusion.
- Correction was successfully achieved using a cantilever technique without performing the planned osteotomy.
Implications:
- This case underscores the potential for dynamic instability in Andersson lesions (ALs) despite quiescent imaging findings.
- Intraoperative reassessment and flexible surgical planning are crucial for managing unexpected changes in spinal instability.
- Successful management of complex spinal deformities in AS can be achieved through adaptive surgical strategies.
