[Fractures of the spine in patients with ankylosing spondylitis]

Eight patients with spine fractures in chronic ankylosing spondylitis have been analyzed. The purpose of this article is to determine possibilities of spine injuries accompanied with this specific rheumatic disease and to show difficulties in diagnosis and problems in treatment. Ankylosing spondylitis affects spine in the way that it ossifficate ligaments, synovial joints and other soft tissue structures. Fractures that occur through these areas involve both bones and ligaments, producing an unstable condition, similar to a shearing type of classic spine injuries. The radiologic diagnosis of these injuries is difficult because the bone is frequently osteoporotic and displacement is of minor degree. In this study, 41.67% of the patients were not diagnosed initially and 16.67% were, for this reason, deteriorated neurologically. Therefore, patients known to have ankylosing spondylitis should be examined regarding the possibility of a fracture, and if pains persist after an injury, they should be thoroughly investigated radiologically to rule out a potentially serious problem. Reduction of the displacement and adequate stabilization, preferably by surgery, should be achieved whenever possible.