Spinal Fractures in Patients With Ankylosing Spondylitis: Etiology, Diagnosis, and Management

The Journal of the American Academy of Orthopaedic Surgeons
Brian C WernerFrancis H Shen

Abstract

In patients with ankylosing spondylitis, the altered biomechanics of the spine increase the incidence of spinal fractures and the risk of subsequent displacement and neurologic injury. Radiographic evaluation is difficult and requires imaging of the entire spine and the use of advanced imaging. Nonsurgical treatment has a high rate of complications and is typically pursued only when surgical intervention would carry unacceptably high perioperative risks. The surgical approach depends on the fracture location and any deformity present. Anterior fixation alone has been associated with high failure rates; therefore, posterior or combined anterior-posterior fixation should be considered. With either nonsurgical or surgical management, complications are frequent and can result in high mortality rates; however, good outcomes can be achieved if an appropriate level of suspicion of fracture is maintained and care is taken to avoid complications related to patient transport, transfer, and positioning.

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Citations

May 8, 2018·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Michael M SafaeeAaron J Clark
Oct 7, 2017·Journal of Neurosurgery. Spine·Frederik R TeunissenJoseph H Schwab
Jun 4, 2020·Continuum : Lifelong Learning in Neurology·Pantelis P Pavlakis
Jan 17, 2021·Emergency Radiology·Riku M VierunenFrank V Bensch
Jul 1, 2021·Curēus·Lim Chia Hua, Sabarul A Mokhtar
Dec 21, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Mayur SharmaDoniel Drazin

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