Spinal Cord Injury and Spinal Fracture in Patients with Ankylosing Spondylitis

2021 ◽  
Author(s):  
Po-Hsun Tu ◽  
Zhuo-Hao Liu ◽  
Mun-Chun Yeap ◽  
Yu-Tse Liu ◽  
Ying-Ching Li ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Ankylosing Spondylitis ◽  
Spinal Fractures ◽  
Spinal Fracture ◽  
Spinal Trauma ◽  
Spinal Epidural Hematoma ◽  
Complication Rates ◽  
Fracture Group ◽  
Cord Injury

Abstract Background Spinal cord injury (SCI) and spinal fracture are major complications in patients with ankylosing spondylitis (AS) who sustain spinal trauma. The purpose of this study is to investigate the incidence, predictors, and sequelae of spinal trauma in patients with AS. Methods This study evaluated our AS patients who had spinal traumas between January 1, 2006, and June 30, 2016 and a comparison of those patients with SCI alone, fracture alone and both SCI and spinal fracture. Results 105 patients were enrolled. Of these patients, 89.5% had spinal fractures, and 57.1% had SCI. Among the patients with spinal fractures, 52.1% had SCI. The existence of bamboo spine was significantly more frequent in the fracture group (78.7% vs. 36.4%; P = 0.006) than in the non-fracture group. The SCI patients had more subluxation or dislocation (48.3% vs. 8.9%; P < 0.001), and more cases of spinal epidural hematoma (SEH) (21.7% vs. 2.2%; P = 0.003) than the non-SCI patients. The rate of delayed diagnosis for spinal fracture was 31.4%, where 1/3 of these patients developed delayed SCI. Among the incomplete SCI patients, 58.3% had neurological improvement after treatment (P = 0.004). Conclusions The patients with existing bamboo spine at X-ray had a higher spinal fracture rate. Spinal fractures involving the C3-C7 region, subluxation or dislocation, spinal fracture severity, and a SEH were found to be predictive of SCI. SCI in AS patients resulted in a high mortality and complication rates.

Spinal Cord Injury and Spinal Fracture in Patients with Ankylosing Spondylitis

2021 ◽  
Author(s):  
Po-Hsun Tu ◽  
Zhuo-Hao Liu ◽  
Mun-Chun Yeap ◽  
Yu-Tse Liu ◽  
Ying-Ching Li ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Ankylosing Spondylitis ◽  
Spinal Fractures ◽  
Spinal Fracture ◽  
Spinal Trauma ◽  
Spinal Epidural Hematoma ◽  
Complication Rates ◽  
Fracture Group ◽  
Cord Injury

Abstract Background: Spinal cord injury (SCI) and spinal fracture are major complications in patients with ankylosing spondylitis (AS) who sustain spinal trauma. The purpose of this study is to investigate the incidence, predictors, and sequelae of spinal trauma in patients with AS.Methods: This study evaluated our AS patients who had spinal traumas between January 1, 2006, and June 30, 2016 and a comparison of those patients with SCI alone, fracture alone and both SCI and spinal fracture.Results: 105 patients were enrolled. Of these patients, 89.5% had spinal fractures, and 57.1% had SCI. Among the patients with spinal fractures, 52.1% had SCI. The existence of bamboo spine was significantly more frequent in the fracture group (78.7% vs. 36.4%; P = 0.006) than in the non-fracture group. The SCI patients had more subluxation or dislocation (48.3% vs. 8.9%; P <0.001), and more cases of spinal epidural hematoma (SEH) (21.7% vs. 2.2%; P = 0.003) than the non-SCI patients. The rate of delayed diagnosis for spinal fracture was 31.4%, where 1/3 of these patients developed delayed SCI. Among the incomplete SCI patients, 58.3% had neurological improvement after treatment (P = 0.004). Conclusions: The patients with existing bamboo spine at X-ray had a higher spinal fracture rate. Spinal fractures involving the C3-C7 region, subluxation or dislocation, spinal fracture severity, and a SEH were found to be predictive of SCI. SCI in AS patients resulted in a high mortality and complication rates.

Spinal cord injury, spinal fracture, and spinal stenosis in ankylosing spondylitis

1982 ◽  
Vol 57 (5) ◽  
pp. 609-616 ◽  
Author(s):  
Philip R. Weinstein ◽  
Robert R. Karpman ◽  
Eric P. Gall ◽  
Michael Pitt
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Ankylosing Spondylitis ◽  
Spinal Stenosis ◽  
Spinal Fracture ◽  
Fracture Site ◽  
Morbidity Rate ◽  
Cervical Spine Fracture ◽  
Cord Injury ◽  
Traumatic Fracture

✓ The authors report a retrospective review of 105 patients with ankylosing spondylitis (AS) diagnosed over a 6-year period in Tucson, Arizona. In the series, there were 13 patients with spinal fracture and eight with severe spinal cord injury. Two patients with central cord contusion had no demonstrable cervical spine fracture. Injury was often trivial and dislocation at fracture sites was minimal, demonstrating the extreme fragility of these patients. Spinal stenosis, which has not previously been associated with AS, was documented in three cases. Pseudarthrosis, a destructive vertebral lesion that does not require surgical decompression or fusion, was found in four patients; this entity is believed to originate as a pathological or traumatic fracture. Atlanto-axial subluxation and basilar invagination associated with spinal ankylosis occurred in one patient. The study emphasizes the value of computerized tomography scanning of the spine for diagnosis, and halo-vest application as a nonoperative treatment for cervical immobilization. Early diagnosis and appropriate therapy to decompress, reduce, and immobilize unstable spinal lesions may result in reduction of the 29% mortality rate and 46% permanent neurological morbidity rate observed after spinal fracture in this series of AS patients. Because of the high operative complication rate observed, nonsurgical immobilization is the recommended treatment unless spinal dislocation or bone fragment displacement has occurred at the fracture site.

scholarly journals Ankylosing spondylitis and spinal cord injury: origin, incidence, management, and avoidance

2008 ◽  
Vol 24 (1) ◽  
pp. E12 ◽  
Author(s):  
W. Bradley Jacobs ◽  
Michael G. Fehlings
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Ankylosing Spondylitis ◽  
Vertebral Column ◽  
Disease Process ◽  
Complex Problem ◽  
Spinal Epidural Hematoma ◽  
High Morbidity ◽  
Cord Injury ◽  
Spinal Epidural

✓ Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that primarily affects the vertebral column and sacroiliac joints. Over time, the disease process promotes extensive remodeling of the spinal axis via ligamentous ossification, vertebral joint fusion, osteoporosis, and kyphosis. These pathological changes result in a weakened vertebral column with increased susceptibility to fractures and spinal cord injury (SCI). Spinal cord injury is often exacerbated by the highly unstable nature of vertebral column fractures in AS. A high incidence of missed fractures in the ankylosed spine as well as an increased incidence of spinal epidural hematoma also worsens the severity of SCI. Spinal cord injury in AS is a complex problem associated with high morbidity and mortality rates, which can be attributed to the severity of the injury, associated medical comorbidities, and the advanced age of most patients with AS who suffer an SCI. In this paper the authors outline the factors that increase the incidence of vertebral column fractures and SCI in AS and discuss the management of SCI in patients with AS. Primary prevention strategies for SCI in patients with AS are outlined as well.

scholarly journals Evolution of traumatic spinal cord injury in patients with ankylosing spondylitis, in a Romanian rehabilitation clinic

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Aurelian Anghelescu ◽  
Liliana Valentina Onose ◽  
Cristina Popescu ◽  
Ioana Andone ◽  
Cristina Octaviana Daia ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Ankylosing Spondylitis ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury ◽  
Rehabilitation Clinic

A Case Report of Ankylosing Spondylitis with Spinal Cord Injury.

1999 ◽  
Vol 48 (1) ◽  
pp. 1-6
Author(s):  
Tatsunobu Abe ◽  
Toyonobu Yoshimura ◽  
Shigetoshi Ito ◽  
Mari Araki ◽  
Hiroshi Kawaguchi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Case Report ◽  
Ankylosing Spondylitis ◽  
Cord Injury

Iatrogenic Spinal Cord Injury in a Trauma Patient with Ankylosing Spondylitis

2017 ◽  
Vol 21 (3) ◽  
pp. 390-394 ◽  
Author(s):  
Ahmad Maarouf ◽  
Colleen M. McQuown ◽  
Jennifer A. Frey ◽  
Rami A. Ahmed ◽  
Lisa Derrick
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Ankylosing Spondylitis ◽  
Trauma Patient ◽  
Cord Injury

scholarly journals (A313) Role of Physiatrists in Post Disaster Scenarios - Lessons Learned from Pakistan, China and Haiti Earthquakes

2011 ◽  
Vol 26 (S1) ◽  
pp. s105-s105
Author(s):  
F.A. Rathore ◽  
C. O'connell ◽  
J. Li
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Community Integration ◽  
Functional Restoration ◽  
Lessons Learned ◽  
Spinal Trauma ◽  
Trauma Patients ◽  
Cord Injury ◽  
Post Disaster

IntroductionPhysical Medicine and Rehabilitation is a goal oriented and patient centered specialty which focuses on functional restoration and quality of life of persons with disability. The patterns of injuries among survivors of recent disasters have, range from mild (single limb fracture) to catastrophic (spinal cord injury, amputation, traumatic brain injury). Historically physiatrists have not participated the acute disaster management phase or in the emergent post disaster rehabilitation planning. This task is usually relegated to the trauma, orthopedic and general surgeons.MethodologyAuthors had firsthand experience in the acute and emergent care and rehabilitation of trauma patients after Pakistan, China and Haiti earthquakes. An electronic literature search (English, 1965–2010, Key words: trauma, rehabilitation, disability, spinal cord injury, amputation, disaster, nerve injury) was carried out. Experience sharing through committees, online forum, and communications were conducted with physiatry colleagues internationally.ResultsIn these three recent earthquakes, Physiatrists provided direct patient care, including guidance in the evacuation of survivors with pre-existing disabilities, transport of persons with spinal trauma, treatment of wounds, fractures, pain, spinal trauma patients and persons with amputations. Physiatrists devised appropriate plans for conservative management of fractures. Education of local staff and coordination of rehabilitation was initiated. Monitoring, prevention and treatment of secondary complications including prolonged immobility, pressure ulcers, chronic pain, urinary, bowel and respiratory dysfunction was performed. Physiatrists helped in patient counseling and family education.ConclusionPhysiatrists by virtue of their training and skills are in a better position to manage the disabilities, including direction of rehabilitation and community integration, prevention of complications, and education and training of health workers and teams. Timely rehabilitation interventions for Spinal cord injuries and lower limb amputations following the Pakistan, China and Haiti earthquakes resulted in reduction in morbidity and mortality among those with catastrophic injuries.

scholarly journals Cervical spinal cord injury complicating ankylosing spondylitis

Spinal Cord ◽  
1985 ◽  
Vol 23 (6) ◽  
pp. 358-363 ◽  
Author(s):  
Dominic Foo ◽  
Mehdi Sarkarati ◽  
Victoria Marcelino
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Ankylosing Spondylitis ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Cord Injury
Sign in / Sign up

Export Citation Format

Share Document