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Fractures of the thoracic and lumbar spine in ankylosing spondylitis

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Summary

In the literature a total of 27 cases of thoracic and lumbar fractures in ankylosing Spondylitis have previously been reported in contrast to cervical fractures which are more common. Transvertebral fractures are relatively rare amounting to 8 cases. The majority of the fractures were transdiscal. Here three additional cases with four fractures are reported. Of these fractures two were transvertebral and two transdiscal. All reported fractures are reviewed regarding age, sex, trauma, fracture localization and type, neurologic complications and fracture healing. Compared to cervical fractures there are less neurological complications in thoracic and lumbar fractures (23%) in ankylosing spondylitis. These fractures mostly heal by moderate immobilisation. Attention should be paid to the possibility of fracture in ankylosing spondylitis even after minor trauma.

Zusammenfassung

In der Literatur sind bisher im ganzen 27 Fälle mit thorakalen oder lumbaren Frakturen bei Spondylitis Ankylopoetica rapportiert worden. Cervikale Frakturen sind dagegen weitaus gewöhnlicher. Transvertebrale Frakturen kommen verhältnismäßig selten vor (8 Fälle). Die Mehrzahl der Frakturen waren transdiskal. Hier werden drei neue Fälle mit vier Frakturen rapportiert. Von diesen Frakturen sind zwei transvertebral und zwei transdiskal. Alle rapportierten Frakturen sind mit Hinsicht auf Alter und Geschlechtszugehörigkeit des Patienten, Trauma, Lokalisation und Typ der Fraktur, neurologische Komplikationen und Frakturheilung rapportiert worden.

Verglichen mit cervikalen Frakturen kommen bei Spondylitis Ankylopoetica weniger neurologische Komplikationen bei thorakalen und lumbaren Frakturen vor (23%). Diese Frakturen heilen meistens nach einer kürzeren Immobilisierung. Die Möglichkeit einer Fraktur bei Spondylitis Ankylopoetica sollte auch bei kleineren Schäden beachtet werden.

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This work was supported by the Swedish Medical Research Council (Project 17X-2031)

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Thorngren, KG., Liedberg, E. & Aspelin, P. Fractures of the thoracic and lumbar spine in ankylosing spondylitis. Arch. Orth. Traum. Surg. 98, 101–107 (1981). https://doi.org/10.1007/BF00460796

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