Clinical outcomes following spinal fracture in patients with ankylosing spondylitis

• Published in: Irish journal of medical science Vol. 186; no. 3; pp. 677 - 681
• Main Authors: Nugent, M., Berney, M. J., Morris, S.
• Format: Journal Article
• Language: English
• Published: London Springer London 01-08-2017
• Subjects: Family Medicine; General Practice; Internal Medicine; Medicine; Medicine & Public Health; Original Article; Spinal fracture; Spinal cord injury; Trauma; Ankylosing spondylitis; Outcomes
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-017-1566-3

Background
Ankylosing spondylitis is a seronegative rheumatoid condition mainly affecting the axial skeleton. It leads to progressive deformity and stiffening of the spine with an increased risk of vertebral fractures and significant neurological deficits compared to the general population.
Aim
This study aimed to evaluate the outcomes of patients with ankylosing spondylitis who sustained acute vertebral fractures over a 10-year period.
Methods
A retrospective review of patient records and radiographic images was performed. Mechanism of injury, fracture type, timing of diagnosis, neurological deficit, management and complications were assessed.
Results
Twenty-four patients were included. Most (23) sustained low energy injuries. Five (20%) patients had a delayed diagnosis over 24 h after the time of injury. Twelve (50%) of patients had a neurological deficit at the time of admission and most did not recover. Eighteen (75%) patients underwent surgical stabilisation. There were 19 complications (in 15 patients) following surgery.
Conclusion
Patients with ankylosing spondylitis are at risk of spinal fracture and associated spinal cord injury after relatively minor trauma. Delayed diagnosis places the patient at risk of neurological compromise, and thus a high index of suspicion is needed when assessing this patient group.