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Ankylosierende Spondylitis

Therapie und Komplikationen von 34 Wirbelsäulenfrakturen

Ankylosing spondylitis

Therapy and complications of 34 spine fractures

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Zusammenfassung

Hintergrund

Wirbelsäulenfrakturen bei ankylosierender Spondylitis (AS) sind extrem instabil und mit einer hohen Komplikationsrate verbunden. Das Ziel dieser retrospektiven Studie ist die Evaluation der Therapie und der Komplikationen dieser Frakturen bei AS zu ihrem besseren Verständnis und Management.

Patienten und Methoden

Von 1981 bis 2002 wurden 32 Patienten mit 34 traumatischen Wirbelsäulenfrakturen behandelt. Der Traumamechanismus, die Frakturlokalisation und der neurologische Status wurden festgehalten. Es erfolgte eine Analyse sowohl des Therapieverfahrens als auch der Komplikationen.

Ergebnisse

Am häufigsten traten Bagatelltraumen im Bereich C 5/6 und C 6/7 auf. Zwei Patienten wurden konservativ, alle übrigen operativ behandelt. Vor der Therapie hatten sechs Patienten eine zervikale Wurzelläsion, zehn einen inkompletten und zwei einen kompletten Querschnitt. Nach der Behandlung besserten sich acht Patienten in ihrem Neurostatus, einer verschlechterte sich. Pulmonale Komplikationen waren am häufigsten zu beobachten.

Schlussfolgerungen

Zur raschen Mobilisierung und Vermeidung weiterer Komplikationen ist eine dorsale oder kombinierte dorsoventrale Stabilisierung der Frakturen notwendig.

Abstract

Background

Spine fractures in ankylosing spondylitis (AS) are extremely unstable and associated with a high complication rate. The aim of this retrospective study was to evaluate the therapy and complications of these fractures in AS for a better understanding and management.

Patients and methods

A total of 32 patients with 34 traumatic spine fractures were treated from 1981 to 2002. Cause of trauma, fracture site, and neurological examination were assessed. Analyses of the management of the treatment and complications were performed.

Results

Banal traumas resulted mostly in spinal fractures at the C 5/6 and C 6/7 level. Two patients were treated conservatively, while the others were stabilized operatively. Before therapy was undertaken, six patients suffered from a cervical radiculopathy, ten patients had an incomplete and two a complete paraplegia. After therapy, neurological status improved in eight patients, but one had a deterioration of neurological symptoms.

Conclusions

Dorsal or combined dorsoventral stabilization of these fractures is necessary for better mobilization of these patients and to avoid further complications.

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Authors and Affiliations

  1. Abteilung für Allgemeine Chirurgie, Klinikum der Eberhard-Karls-Universität Tübingen

    M. Zdichavsky

  2. Abteilung für Unfallchirurgie, Medizinische Hochschule Hannover

    U. Lange, C. Krettek & L. Bastian

  3. Abteilung für Unfallchirurgie, Leopold-Franzens Universität Innsbruck

    M. Blauth & C. Knop

  4. Abteilung für Allgemeine Chirurgie, Klinikum der Eberhard-Karls-Universität, Hoppe-Seyler-Straße 3, 72076, Tübingen

    M. Zdichavsky

Authors
  1. M. Zdichavsky
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  2. M. Blauth
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  3. C. Knop
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  4. U. Lange
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  5. C. Krettek
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  6. L. Bastian
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Correspondence to M. Zdichavsky.

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Zdichavsky, M., Blauth, M., Knop, C. et al. Ankylosierende Spondylitis. Chirurg 76, 967–976 (2005). https://doi.org/10.1007/s00104-005-1023-0

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  • DOI: https://doi.org/10.1007/s00104-005-1023-0

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