Skip to main content
SpringerLink
Log in

The spine in sickle cell disease

  • Published:
International Orthopaedics Aims and scope Submit manuscript

Summary

Bone changes in sickle cell disease occur due to marrow hyperplasia, tissue ischaemia and infarction due to vaso-occlusion. Between 1982 and 1991 thirty four patients were treated in the Orthopaedic and Neurosurgery Departments of the Kind Fahd University Hospital, Al-Khobar, with spinal complications due to sickle cell disease. There were 21 males and 13 females aged between 4 and 28 years (mean 17.4 years). Structural changes in the vertebral bodies due to marrow hyperplasia occurred in 44% of the patients. Avascular necrosis leading to collapse of the vertebral bodies was seen in 9 (27%) patients. Infective spondylitis was the most serious complication seen in 8 (24%) patients; the majority needed anterolateral decompression and bone grafting. The spine is often affected in sickle cell disease and aggressive treatment with close follow-up is required to avoid disabling complications.

Résumé

Les modifications osseuses survenant au cours de la drépanocytose sont la conséquence d'une hyperplasie médullaire, d'une ischémie tissulaire et d'un infarcissement liés à l'occlusion vasculaire. Cette étude rétrospective analyse les complications rachidiennes de la drépanocytose observées de 1982 à 1991. Trente-quatre patients ont été traités dans les services d'orthopédie et de neuro-chirurgie de l'Hôpital universitaire King Fahd à Al Khobar. Il s'agissait de 21 hommes et de 13 femmes, âǵes en moyenne de 17.4 ans, avec des extrêmes de 4 à 28 ans. Des modifications structurales du corps vertébral liées à l'hyperplasie médullaire sont survenues chez 44% des patients. Des nécroses avasculaires responsables d'un effondrement du corps vertébral ont été observéees chez 9 patients (26.5%). La spondylite infectieuse, qui constitue la complication la plus grave, a concerné 8 patients (23.5%), dont la plupart ont bénéficié d'une décompression antérolatérale et de greffes osseuses. Nous pensons que le rachis est souvent atteint au cours de la drépanocytose et qu'un traitement agressif et une étroite surveillance sont nécessaires pour éviter des séquelles majeures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adeyokunnu AA, Hendrickse RG (1980) Salmonella osteomyelitis in childhood. Arch Dis Child 55: 175–184

    Google Scholar 

  2. Al-Awamy HB (1987) Sickle cell anemia. Its clinical manifestations and its management. Saudi Med J 8: 553–562

    Google Scholar 

  3. Al-Awamy BH, Sumer T, Naeem MA et al. (1986) Pathological fractures of vertebral column in association with sickle cell anemia in Saudi Arabia. Trop Georgr Med 38: 421–424

    Google Scholar 

  4. Al-Dabbagh AA, Acquaya JK, Al-Baghdadi TM et al (1989) Radiological bone changes of sickle cell anemia in western Saudi Arabia. Saudi Med J 10: 367–371

    Google Scholar 

  5. Diggs LW (1967) Bone and joint lesions in sickle cell disease. Clin Orthop 52: 119–143

    Google Scholar 

  6. Diggs LW, Pulliam HM, King JC (1937): The bone changes in sickle cell anemia. South MJ 30: 249–259

    Google Scholar 

  7. Golding JSR (1956) The bone changes in sickle cell anemia. Ann R Coll Surg Eng 19: 296–315

    Google Scholar 

  8. Henkin WA (1949) Collapse of the vertebral bodies in sickle cell anemia. AJR 62: 395–401

    Google Scholar 

  9. Hughes JG, Carrol DS (1957) Salmonella osteomyelitis complicating sickle cell disease. Pediatrics 19: 184–191

    Google Scholar 

  10. Karayalcin G, Rosner F, Kim KY et al. (1975) Sickle cell anemia. Clinical manifestations in 100 patients and review of literature. Am J Med Sci 269: 51–68

    Google Scholar 

  11. Leivy FE, Schnabel TG (1932) Abdominal crisis in sickle cell anemia. Am J Med Sci 183: 381–391

    Google Scholar 

  12. Mallouh A, Talab Y (1985) Bone and joint infections in patients with sickle cell disease. J Pediatr Orthop 5: 158–162

    Google Scholar 

  13. Mallouh A, Kilani RA, Talab Y (1990) Osteomyelitis and septic arthritis in sickle cell disease, clinical, laboratory, radiographic, bacteriologic and management aspects. The First Scientific Symposium on Sickle Cell Anemia. Dammam, pp 32–33

  14. Mandell GA, Kricum ME (1979) Exaggerated anterior vertebral notching. Pediatric Radiol 131: 367–369

    Google Scholar 

  15. Sadat-Ali M (1990) The present status of osteomyelitis in sickle cell disease. The First Scientific Symposium on Sickle Cell Anemia. Dammam, p 34

  16. Sadat-Ali M (1993) Avascular necrosis of femoral head in sickle cell disease: an integrated classification. Clin Orthop 290: 200–205

    Google Scholar 

  17. Sadat-Ali M, Sankaran-Kutty M, Kutty MK (1985) Recent Observations on osteomyelitis in sickle cell disease. Int Orthop 9: 97–99

    Google Scholar 

  18. Sadat-Ali M, Sankaran-Kutty M (1984) Avascular necrosis of femoral head in sickle cell disease. Arab J Med 3: 19–21

    Google Scholar 

  19. Sadat-Ali M, Al-Salem AH (1991) Orthopaedic complications in sickle cell disease in eastern Saudi Arabia. Indian Pract LXIV: 215–220

    Google Scholar 

  20. Theis JC and Owen R (1988) Skeletal complications in sickle cell disease in UK. J R Coll Surg Edinb 33: 306–310

    Google Scholar 

  21. Weens HS (1945) Cholelithiasis in sickle cell anemia. Ann Int Med 22: 182–191

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, College of Medicine and Medical Sciences, King Faisal University, Dammam, Saudi Arabia

    M. Sadat-Ali & J. Ran Corea

  2. Department of Neurosurgery, College of Medicine and Medical Sciences, King Faisal University, Dammam, Saudi Arabia

    A. Ammar & A. W. Ibrahim

Authors
  1. M. Sadat-Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Ammar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Ran Corea
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. W. Ibrahim
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sadat-Ali, M., Ammar, A., Corea, J.R. et al. The spine in sickle cell disease. International Orthopaedics 18, 154–156 (1994). https://doi.org/10.1007/BF00192471

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00192471

Keywords

Search

Navigation