Spinal fractures complicating ankylosing spondylitis. A long-term followup study

Area of Science:

• Orthopedics
• Rheumatology
• Neurosurgery

Background:

• Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine.
• Spinal fractures in AS patients present unique diagnostic and management challenges.
• The biomechanical properties of the fused and rigid spine in AS increase fracture risk.

Purpose of the Study:

• To report on spinal fractures in patients with chronic ankylosing spondylitis.
• To analyze fracture locations, causes, and outcomes.
• To discuss diagnostic and management difficulties.

Main Methods:

• Retrospective case series.
• Review of 22 spinal fractures in 20 patients with chronic ankylosing spondylitis.
• Long-term follow-up of conservatively managed and delayed-diagnosis fractures.

Main Results:

• Nineteen of 22 fractures were in the cervical region.
• Common causes included minor falls (14), falls down steps (3), motor vehicle accidents (4), and CPR (1).
• All 9 conservatively managed fractures achieved bony union; no neurological deterioration occurred, with 3 major recoveries.

Conclusions:

• Spinal fractures, particularly cervical, are a significant complication in ankylosing spondylitis.
• Early diagnosis and conservative management appear effective, yielding positive outcomes.
• Delayed diagnosis can complicate management, highlighting the need for vigilance.