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01-02-2009 | Review

Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications

Authors: L. A. Westerveld, J. J. Verlaan, F. C. Oner

Published in: European Spine Journal | Issue 2/2009

Abstract

The ankylosed spine is prone to fracture after minor trauma due to its changed biomechanical properties. Although many case reports and small series have been published on patients with ankylosing spondylitis (AS) suffering spine fractures, solid data on clinical outcome are rare. In advanced diffuse idiopathic skeletal hyperostosis (DISH), ossification of spinal ligaments also leads to ankylosis. The prevalence of AS is stable, but since DISH may become more widespread due to its association with age, obesity and type 2 diabetes mellitus, a systematic review of the literature was conducted to increase the current knowledge on treatment, neurological status and complications of patients with preexisting ankylosed spines sustaining spinal trauma. A literature search was performed to obtain all relevant articles concerning the outcome of patients with AS or DISH admitted with spinal fractures. Predefined parameters were extracted from the papers and pooled to study the effect of treatment on neurological status and complications. Ninety-three articles were included, representing 345 AS patients and 55 DISH patients. Most fractures were localized in the cervical spine and resulted from low energy impact. Delayed diagnosis often occurred due to patient and doctor related factors. On admission 67.2% of the AS patients and 40.0% of the DISH patients demonstrated neurologic deficits, while secondary neurological deterioration occurred frequently. Surgical or nonoperative treatment did not alter the neurological prospective for most patients. The complication rate was 51.1% in AS patients and 32.7% in DISH patients. The overall mortality within 3 months after injury was 17.7% in AS and 20.0% in DISH. This review suggests that the clinical outcome of patients with fractures in previously ankylosed spines, due to AS or DISH, is considerably worse compared to the general trauma population. Considering the potential increase in prevalence of DISH cases, this condition may render a new challenge for physicians treating spinal injuries.

Akman MN, Karatas M, Kilinc S et al (1999) Double spinal cord injury in a patient with ankylosing spondylitis. Spinal Cord 37:305–307. doi:10.1038/sj.sc.3100754 PubMed

Amamilo SC (1989) Fractures of the cervical spine in patients with ankylosing spondylitis. Orthop Rev 18:339–344PubMed

American College of Surgeons Advanced Trauma Life Support for Doctors, Student Course Manual (1997). American College of Surgeons, Chicago

American Spinal Injury Association IMSoP International standards for neurologic and functional classification of spinal cord injury (1992). ASIA/IMSOP, Chicago

Baron M, Tator CH, Little H (1980) Hangman’s fracture in ankylosing spondylitis preceded by vertical subluxation of the axis. Arthritis Rheum 23:850–855. doi:10.1002/art.1780230712 PubMed

Belanger TA, Rowe DE (2001) Diffuse idiopathic skeletal hyperostosis: musculoskeletal manifestations. J Am Acad Orthop Surg 9:258–267PubMed

Bernini PM, Floman Y, Marvel J et al (1981) Multiple thoracic spine fractures complicating ankylosing hyperostosis of the spine. J Trauma 21:811–814. doi:10.1097/00005373-198109000-00012 PubMed

Bobyn JD, Mortimer ES, Glassman AH et al (1992) Producing and avoiding stress shielding. Laboratory and clinical observations of noncemented total hip arthroplasty. Clin Orthop Relat Res 274:79–96PubMed

Boriani S, Romano B (1983) Spinal lesions due to hyperextension in ankylosing spondylitis. Ital J Orthop Traumatol 9:365–368PubMed

10.

Braun J, Sieper J (2007) Ankylosing spondylitis. Lancet 369:1379–1390. doi:10.1016/S0140-6736(07)60635-7 PubMed

11.

Broom MJ, Raycroft JF (1988) Complications of fractures of the cervical spine in ankylosing spondylitis. Spine 13:763–766. doi:10.1097/00007632-198807000-00009 PubMed

12.

Burkus JK, Denis F (1994) Hyperextension injuries of the thoracic spine in diffuse idiopathic skeletal hyperostosis. Report of four cases. J Bone Joint Surg Am 76:237–243PubMed

13.

Byrnes MC, McDaniel MD, Moore MB et al (2005) The effect of obesity on outcomes among injured patients. J Trauma 58:232–237. doi:10.1097/01.TA.0000152081.67588.10 PubMed

14.

Callahan EP, Aguillera H (1993) Complications following minor trauma in a patient with diffuse idiopathic skeletal hyperostosis. Ann Emerg Med 22:1067–1070. doi:10.1016/S0196-0644(05)82754-4 PubMed

15.

Chong CF (2004) Fracture of the delicate bamboo: a diagnostic pitfall. Ann Emerg Med 44:88–89. doi:10.1016/j.annemergmed.2004.01.030 PubMed

16.

Corke CF (1981) Spinal fracture and paraplegia after minimal trauma in a patient with ankylosing vertebral hyperostosis. Br Med J (Clin Res Ed) 282:2035

17.

Cornefjord M, Alemany M, Olerud C (2005) Posterior fixation of subaxial cervical spine fractures in patients with ankylosing spondylitis. Eur Spine J 14:401–408. doi:10.1007/s00586-004-0733-1 PubMed

18.

Denko CW, Malemud CJ (2006) Body mass index and blood glucose: correlations with serum insulin, growth hormone, and insulin-like growth factor-1 levels in patients with diffuse idiopathic skeletal hyperostosis (DISH). Rheumatol Int 26:292–297. doi:10.1007/s00296-005-0588-8 PubMed

19.

Detwiler KN, Loftus CM, Godersky JC et al (1990) Management of cervical spine injuries in patients with ankylosing spondylitis. J Neurosurg 72:210–215PubMed

20.

Einsiedel T, Kleimann M, Nothofer W et al (2001) Special problems and management in lesions of cervical spine affected by Bechterew’s disease. Unfallchirurg 104:1129–1133. doi:10.1007/s001130170003 PubMed

21.

Einsiedel T, Schmelz A, Arand M et al (2006) Injuries of the cervical spine in patients with ankylosing spondylitis: experience at two trauma centers. J Neurosurg Spine 5:33–45. doi:10.3171/spi.2006.5.1.33 PubMed

22.

El Masry MA, Badawy WS, Chan D (2004) Combined anterior and posterior stabilisation for treating an unstable cervical spine fracture in a patient with long standing ankylosing spondylitis. Injury 35:1064–1067PubMed

23.

Exner G, Botel U, Kluger P et al (1998) Treatment of fracture and complication of cervical spine with ankylosing spondylitis. Spinal Cord 36:377–379. doi:10.1038/sj.sc.3100673 PubMed

24.

Fast A, Parikh S, Marin EL (1986) Spine fractures in ankylosing spondylitis. Arch Phys Med Rehabil 67:595–597PubMed

25.

Fazl M, Bilbao JM, Hudson AR (1981) Laceration of the aorta complicating spinal fracture in ankylosing spondylitis. Neurosurgery 8:732–734. doi:10.1097/00006123-198106000-00019 PubMed

26.

Ferree BA, Wieser M, Clarke RP (1989) Hyperextension spinal fracture. Orthop Rev 18:1061–1064PubMed

27.

Finkelstein JA, Chapman JR, Mirza S (1999) Occult vertebral fractures in ankylosing spondylitis. Spinal Cord 37:444–447. doi:10.1038/sj.sc.3100837 PubMed

28.

Fishman EK, Magid D (1992) Cervical fracture in ankylosing spondylitis: value of multidimensional imaging. Clin Imaging 16:31–33. doi:10.1016/0899-7071(92)90086-O PubMed

29.

Foo D, Bignami A, Rossier AB (1983) Two spinal cord lesions in a patient with ankylosing spondylitis and cervical spine injury. Neurology 33:245–249PubMed

30.

Foo D, Rossier AB (1982) Post-traumatic spinal epidural hematoma. Neurosurgery 11:25–32. doi:10.1097/00006123-198207010-00006 PubMed

31.

Foo D, Sarkarati M, Marcelino V (1985) Cervical spinal cord injury complicating ankylosing spondylitis. Paraplegia 23:358–363PubMed

32.

Gartman J, Bullitt E, Baker ML (1991) Axis fracture in ankylosing spondylitis: case report. Neurosurgery 29:590–594. doi:10.1097/00006123-199110000-00018 PubMed

33.

Garza-Mercado R (1989) Traumatic extradural hematoma of the cervical spine. Neurosurgery 24:410–414. doi:10.1097/00006123-198903000-00018 PubMed

34.

Gelineck J, De Carvalho A (1990) Fractures of the spine in ankylosing spondylitis. RoFo 152:307–310PubMed

35.

Gertzbein SD (1992) Scoliosis Research Society. Multicenter spine fracture study. Spine 17:528–540PubMed

36.

Govender S, Charles RW (1987) Fracture of the dens in ankylosing spondylitis. Injury 18:213–214. doi:10.1016/0020-1383(87)90141-0 PubMed

37.

Graham B, Van Peteghem PK (1989) Fractures of the spine in ankylosing spondylitis. Diagnosis, treatment and complications. Spine 14:803–807. doi:10.1097/00007632-198908000-00005 PubMed

38.

Gretschel S, Estevez-Schwarz L, Hunerbein M et al (2006) Gastric cancer surgery in elderly patients. World J Surg 30:1468–1474. doi:10.1007/s00268-005-0633-5 PubMed

39.

Grisolia A, Bell RL, Peltier LF (2004) Fractures and dislocations of the spine complicating ankylosing spondylitis: a report of six cases 1967. Clin Orthop Relat Res 422:129–134. doi:10.1097/01.blo.0000131643.61246.0a PubMed

40.

Hanson JA, Mirza S (2000) Predisposition for spinal fracture in ankylosing spondylitis. AJR Am J Roentgenol 174:150PubMed

41.

Harrop JS, Sharan A, Anderson G et al (2005) Failure of standard imaging to detect a cervical fracture in a patient with ankylosing spondylitis. Spine 30:E417–E419. doi:10.1097/01.brs.0000170594.45021.67 PubMed

42.

Hendrix RW, Melany M, Miller F et al (1994) Fracture of the spine in patients with ankylosis due to diffuse skeletal hyperostosis: clinical and imaging findings. AJR Am J Roentgenol 162:899–904PubMed

43.

Hertlein H, Schams S, Lob G (1991) Extension-distraction injury of the lumbar spine in spondylarthrosis ankylopoetica. Unfallchirurgie 17:259–263. doi:10.1007/BF02588404 PubMed

44.

Heyde CE, Robinson Y, Kayser R et al (2007) Fatal complex fracture of the cervical spine in a patient with ankylosing spondylitis after a fall from a racing bicycle. Sportverletz Sportschaden 21:148–151. doi:10.1055/s-2007-963315 PubMed

45.

Hitchon PW, From AM, Brenton MD et al (2002) Fractures of the thoracolumbar spine complicating ankylosing spondylitis. J Neurosurg 97:218–222PubMed

46.

Hollis S, Lecky F, Yates DW et al (2006) The effect of pre-existing medical conditions and age on mortality after injury. J Trauma 61:1255–1260. doi:10.1097/01.ta.0000243889.07090.da PubMed

47.

Horn EM, Theodore N, Feiz-Erfan I et al (2006) Complications of halo fixation in the elderly. J Neurosurg Spine 5:46–49. doi:10.3171/spi.2006.5.1.46 PubMed

48.

Hornick TR (2006) Surgical innovations: impact on the quality of life of the older patient. Clin Geriatr Med 22:499–513. doi:10.1016/j.cger.2006.05.005 PubMed

49.

Houk RW, Hendrix RW, Lee C et al (1984) Cervical fracture and paraplegia complicating diffuse idiopathic skeletal hyperostosis. Arthritis Rheum 27:472–475. doi:10.1002/art.1780270418 PubMed

50.

Hunter T, Dubo HIC (1983) Spinal fractures complicating ankylosing spondylitis. A long-term followup study. Arthritis Rheum 26:751–759. doi:10.1002/art.1780260608 PubMed

51.

Hunter T, Forster B, Dvorak M (1995) Ankylosed spines are prone to fracture. Can Fam Physician 41:1213–1216PubMed

52.

Iplikcioglu AC, Bayar MA, Kokes F et al (1994) Magnetic resonance imaging in cervical trauma associated with ankylosing spondylitis: report of two cases. J Trauma 36:412–413. doi:10.1097/00005373-199403000-00026 PubMed

53.

Irwin ZN, Arthur M, Mullins RJ et al (2004) Variations in injury patterns, treatment, and outcome for spinal fracture and paralysis in adult versus geriatric patients. Spine 29:796–802. doi:10.1097/01.BRS.0000119400.92204.B5 PubMed

54.

Israel Z, Mosheiff R, Gross E et al (1994) Hyperextension fracture-dislocation of the thoracic spine with paraplegia in a patient with diffuse idiopathic skeletal hyperostosis. J Spinal Disord 7:455–457. doi:10.1097/00002517-199410000-00013 PubMed

55.

Juric G, Coumas JM, Giansiracusa DF et al (1990) Hemothorax—An unusual presentation of spinal fracture in ankylosing spondylitis. J Rheumatol 17:263–266PubMed

56.

Kao LS, Todd SR, Moore FA (2006) The impact of diabetes on outcome in traumatically injured patients: an analysis of the National Trauma Data Bank. Am J Surg 192:710–714. doi:10.1016/j.amjsurg.2006.08.031 PubMed

57.

Kaplan SL, Tun CG, Sarkarati M (1990) Odontoid fracture complicating ankylosing spondylitis: a case report and review of the literature. Spine 15:607–610. doi:10.1097/00007632-199006000-00037 PubMed

58.

Kauppi M, Belt EA, Soini I (2000) ‘Bamboo spine’ starts to bend—Something is wrong. Clin Exp Rheumatol 18:513–514PubMed

59.

Kessler T, Quintel M, Winkler H et al (1996) Lethal transverse fracture through the body of C6 with tracheal lesion in ankylosing spondylitis: case report. Unfallchirurg 99:525–529PubMed

60.

Kim SK, Choi BR, Kim CG et al (2004) The prevalence of diffuse idiopathic skeletal hyperostosis in Korea. J Rheumatol 31:2032–2035PubMed

61.

Kiss C, Szilagyi M, Paksy A et al (2002) Risk factors for diffuse idiopathic skeletal hyperostosis: a case-control study. Rheumatology (Oxford) 41:27–30. doi:10.1093/rheumatology/41.1.27

62.

Kiwerski J, Wieclawek H, Garwacka I (1985) Fractures of the cervical spine in ankylosing spondylitis. Int Orthop 8:243–246. doi:10.1007/BF00266867 PubMed

63.

Knop C, Blauth M, Buhren V et al (2001) Surgical treatment of injuries of the thoracolumbar transition-3: Follow-up examination. Results of a prospective multi-center study by the “Spinal” Study Group of the German Society of Trauma Surgery. Unfallchirurg 104:583–600. doi:10.1007/s001130170089 PubMed

64.

Lahoti OP, Callanan I, Reidy DP et al (1995) Hidden flexion injury of the cervical spine in ankylosing spondylitis. Injury 26:67–69. doi:10.1016/0020-1383(95)90560-K PubMed

65.

Lange U, Pape HC, Bastian L et al (2005) Operative management of cervical spine injuries in patients with Bechterew’s disease. Unfallchirurg 108:63–68. doi:10.1007/s00113-004-0793-z PubMed

66.

Le Hir PX, Sautet A, Le GL et al (1999) Hyperextension vertebral body fractures in diffuse idiopathic skeletal hyperostosis: a cause of intravertebral fluidlike collections on MR imaging. AJR Am J Roentgenol 173:1679–1683PubMed

67.

Liang CL, Lu K, Lee TC et al (2002) Dissociation of atlantoaxial junction in ankylosing spondylitis: case report. J Trauma 53:1173–1175. doi:10.1097/00005373-200212000-00024 PubMed

68.

Lifshutz J, Lidar Z, Maiman D (2005) Thoracic aortic pseudoaneurysm after spine trauma in ankylosing spondylitis. Case report. J Neurosurg Spine 2:218–221PubMedCrossRef

69.

Mac Millan M, Stauffer ES (1991) Traumatic instability in the previously fused cervical spine. J Spinal Disord 4:449–454PubMed

70.

Mader R (2002) Clinical manifestations of diffuse idiopathic skeletal hyperostosis of the cervical spine. Semin Arthritis Rheum 32:130–135. doi:10.1053/sarh.2002.33726 PubMed

71.

Majercik S, Tashjian RZ, Biffl WL et al (2005) Halo vest immobilization in the elderly: a death sentence? J Trauma 59:350–356. doi:10.1097/01.ta.0000174671.07664.7c PubMed

72.

Malik SA, Murphy M, Connolly P et al (2008) Evaluation of morbidity, mortality and outcome following cervical spine injuries in elderly patients. Eur Spine J 17:585–591PubMed

73.

Markel DC, Graziano GP (1992) Fracture of the S1 vertebral body in a patient with ankylosing spondylitis. J Spinal Disord 5:222–226. doi:10.1097/00002517-199206000-00014 PubMed

74.

Maskery NSS, Burrows N (2002) Cervical spine control; Bending the rules. Emerg Med J 19:592–593. doi:10.1136/emj.19.6.592 PubMed

75.

Matejka J (2006) Hyperextension injuries of the thoracolumbar spine. Zentralbl Chir 131:75–79. doi:10.1055/s-2006-921391 PubMed

76.

May PJ, Raunest J, Herdmann J et al (2002) Management of vertebral fractures in ankylosing spondylitis. Unfallchirurg 105:165–169. doi:10.1007/s001130100326 PubMed

77.

McCall I, El Masri W, Jaffray D (1985) Hangman’s fracture in ankylosing spondylitis. Injury 16:483–484. doi:10.1016/0020-1383(85)90174-3 PubMed

78.

McGwin G Jr, Maclennan PA, Fife JB et al (2004) Preexisting conditions and mortality in older trauma patients. J Trauma 56:1291–1296. doi:10.1097/01.TA.0000089354.02065.D0 PubMed

79.

McKenzie MK, Bartal E, Pay NT (1991) A hyperextension injury of the thoracic spine in association with diffuse idiopathic skeletal hyperostosis. Orthopedics 14:895–898PubMed

80.

Miller FH, Rogers LF (1991) Fractures of the dens complicating ankylosing spondylitis with atlantooccipital fusion. J Rheumatol 18:771–774PubMed

81.

Mody GM, Charles RW, Ranchod HA et al (1988) Cervical spine fracture in diffuse idiopathic skeletal hyperostosis. J Rheumatol 15:129–131PubMed

82.

Moreau APM, Willcox N, Brown MF (2003) Immobilisation of spinal fractures in patients with ankylosing spondylitis: two case reports. Injury 34:372–373. doi:10.1016/S0020-1383(01)00190-5 PubMed

83.

Murray GC, Persellin RH (1981) Cervical fracture complicating ankylosing spondylitis. A report of eight cases and review of the literature. Am J Med 70:1033–1041. doi:10.1016/0002-9343(81)90860-3 PubMed

84.

Neville AL, Brown CV, Weng J et al (2004) Obesity is an independent risk factor of mortality in severely injured blunt trauma patients. Arch Surg 139:983–987. doi:10.1001/archsurg.139.9.983 PubMed

85.

Olerud C, Frost A, Bring J (1996) Spinal fractures in patients with ankylosing spondylitis. Eur Spine J 5:51–55. doi:10.1007/BF00307827 PubMed

86.

Oxford Centre for Evidence-based Medicine (2001). Levels of Evidence. [http://www.cebm.net/index.aspx?o=1025]

87.

Ozgocmen S, Ardicoglu O (2000) Odontoid fracture complicating ankylosing spondylitis. Spinal Cord 38:117–119. doi:10.1038/sj.sc.3100926 PubMed

88.

Paley D, Schwartz M, Cooper P et al (1991) Fractures of the spine in diffuse idiopathic skeletal hyperostosis. Clin Orthop Relat Res 267:22–32PubMed

89.

Papadopoulos MC, Chakraborty A, Waldron G et al (1999) Lesson of the week: exacerbating cervical spine injury by applying a hard collar. BMJ 319:171–172PubMed

90.

Pascal-Moussellard H, Drossard G, Cursolles JC et al (2006) Myelopathy by lesions of the craniocervical junction in a patient with forestier disease. Spine 31:E557–E560. doi:10.1097/01.brs.0000225972.24608.be PubMed

91.

Payer M (2006) Surgical management of cervical fractures in ankylosing spondylitis using a combined posterior–anterior approach. J Clin Neurosci 13:73–77. doi:10.1016/j.jocn.2005.02.010 PubMed

92.

Peh WC (2001) A 33-year-old man presented with progressive neck pain and a subjective sensation of neck instability. Diagnosis: type II dens fracture complicating ankylosing spondylitis. Australas Radiol 45:101–103. doi:10.1046/j.1440-1673.2001.00884.x PubMed

93.

Peh WCG, Ho EKW (1995) Fracture of the odontoid peg in ankylosing spondylitis: case report. J Trauma 38:361–363. doi:10.1097/00005373-199503000-00009 PubMedCrossRef

94.

Podolsky SM, Hoffman JR, Pietrafesa CA (1983) Neurologic complications following immobilization of cervical spine fracture in a patient with ankylosing spondylitis. Ann Emerg Med 12:578–580. doi:10.1016/S0196-0644(83)80305-9 PubMed

95.

Pofahl WE, Pories WJ (2003) Current status and future directions of geriatric general surgery. J Am Geriatr Soc 51:S351–S354. doi:10.1046/j.1365-2389.2003.51347.x PubMed

96.

Resnick D, Shaul SR, Robins JM (1975) Diffuse idiopathic skeletal hyperostosis (DISH): Forestier’s disease with extraspinal manifestations. Radiology 115:513–524PubMed

97.

Roosen K, Wissing H, Grote W et al (1985) Operative stabilization of fractures in the cervical spine in Bechterew’s disease. Unfallchirurg 88:215–218PubMed

98.

Ruf M, Rehm S, Poeckler-Schoeniger C et al (2006) Iatrogenic fractures in ankylosing spondylitis - A report of two cases. Eur Spine J 15:100–104. doi:10.1007/s00586-005-0973-8 PubMed

99.

Samartzis D, Anderson DG, Shen FH (2005) Multiple and simultaneous spine fractures in ankylosing spondylitis: case report. Spine 30:E711–E715. doi:10.1097/01.brs.0000188272.19229.74 PubMed

100.

Savolaine ER, Ebraheim NA, Stitgen S et al (1991) Aortic rupture complicating a fracture of an ankylosed thoracic spine: a case report. Clin Orthop Relat Res 272:136–140PubMed

101.

Schaberg J (1986) Aortic injury occurring after minor trauma in ankylosing spondylitis. J Vasc Surg 4:410–411. doi:10.1067/mva.1986.avs0040410 PubMed

102.

Schroder J, Liljenqvist U, Greiner C et al (2003) Complications of halo treatment for cervical spine injuries in patients with ankylosing spondylitis—report of three cases. Arch Orthop Trauma Surg 123:112–114PubMed

103.

Secin FP, Poggi EJ, Luzuriaga F et al (1999) Disabling injuries of the cervical spine in Argentine rugby over the last 20 years. Br J Sports Med 33:33–36PubMed

104.

Sharma RR, Mahapatra A, Pawar SJ et al (2001) Spinal cord and cauda equina compression in ‘DISH’. Neurol India 49:148–152PubMed

105.

Shen FH, Samartzis D (2005) Cervical spine fracture in the ankylosing spondylitis patient. J Am Coll Surg 200:632–633. doi:10.1016/j.jamcollsurg.2004.07.036 PubMed

106.

Shen FH, Samartzis D (2007) Successful nonoperative treatment of a three-column thoracic fracture in a patient with ankylosing spondylitis: existence and clinical significance of the fourth column of the spine. Spine 32:E423–E427. doi:10.1097/BRS.0b013e318074d59f PubMed

107.

Smyth S, Heron A (2006) Diabetes and obesity: the twin epidemics. Nat Med 12:75–80. doi:10.1038/nm0106-75 PubMed

108.

Sreedharan S, Li YH (2005) Diffuse idiopathic skeletal hyperostosis with cervical spinal cord injury— a report of 3 cases and a literature review. Ann Acad Med Singapore 34:257–261PubMed

109.

Stechison MT, Tator CH (1990) Cervical myelopathy in diffuse idiopathic skeletal hyperostosis. Case report. J Neurosurg 73:279–282PubMed

110.

Straiton N (1987) Fractures of the lower vertebral column in ankylosing spondylitis. Br J Clin Pract 41:933–934PubMed

111.

Strohm PC, Zwingmann J, Bley TA et al (2006) Injuries of the cervical spine with Forestier’s disease: problems in the diagnostic and surgical management. Unfallchirurg 109:905–909. doi:10.1007/s00113-006-1114-5 PubMed

112.

Surin VV (1980) Fractures of the cervical spine in patients with ankylosing spondylitis. Acta Orthop Scand 51:79–84PubMedCrossRef

113.

Taggard DA, Traynelis VC (2000) Management of cervical spinal fractures in ankylosing spondylitis with posterior fixation. Spine 25:2035–2039. doi:10.1097/00007632-200008150-00006 PubMed

114.

Tait TJ, Barlow G, Iveson JMI (1998) Cervical spine fracture in ankylosing spondylitis: a case of ‘auto-fracture’. Br J Rheumatol 37:467–468. doi:10.1093/rheumatology/37.4.467 PubMed

115.

Tashjian RZ, Majercik S, Biffl WL et al (2006) Halo-vest immobilization increases early morbidity and mortality in elderly odontoid fractures. J Trauma 60:199–203. doi:10.1097/01.ta.0000197426.72261.17 PubMed

116.

Tetzlaff JE, Yoon HJ, Bell G (1998) Massive bleeding during spine surgery in a patient with ankylosing spondylitis. Can J Anaesth 45:903–906PubMed

117.

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

118.

Thumbikat P, Hariharan RP, Ravichandran G et al (2007) Spinal cord injury in patients with ankylosing spondylitis: a 10-year review. Spine 32:2989–2995PubMed

119.

Tico N, Ramon S, Garcia-Ortun F et al (1998) Traumatic spinal cord injury complicating ankylosing spondylitis. Spinal Cord 36:349–352. doi:10.1038/sj.sc.3100619 PubMed

120.

Tiesenhausen K, Thalhammer M, Koch G et al (2001) Traumatic aortic rupture in ankylosing spondylitis—a lethal complication. Unfallchirurg 104:1101–1103. doi:10.1007/s001130170025 PubMed

121.

Trent G, Armstrong GWD, O’Neil J (1988) Thoracolumbar fractures in ankylosing spondylitis: high-risk injuries. Clin Orthop Relat Res 227:61–66PubMed

122.

Upadhyay SS, Ho EK, Hsu LC (1991) Positioning for plain spinal radiography producing paraplegia in a patient with ankylosing spondylitis. Br J Radiol 64:549–551PubMed

123.

van der Linden S (1997) Ankylosing spondylitis. In: Kelley WN, Harris S, Ruddy S et al Textbook of Rheumatology, 5th edn. WB Saunders, Philadelphia, 2:969–982

124.

Verlaan JJ, Diekerhof CH, Buskens E et al (2004) Surgical treatment of traumatic fractures of the thoracic and lumbar spine: a systematic review of the literature on techniques, complications, and outcome. Spine 29:803–814. doi:10.1097/01.BRS.0000116990.31984.A9 PubMed

125.

Vives MJ, Harris C, Reiter MF et al (2007) Use of stand-up magnetic resonance imaging for evaluation of a cervicothoracic injury in a patient with ankylosing spondylitis. Spine J [Epub ahead of print]

126.

Wade W, Saltzstein R, Maiman D (1989) Spinal fractures complicating ankylosing spondylitis. Arch Phys Med Rehabil 70:398–401PubMed

127.

Weinfeld RM, Olson PN, Maki DD et al (1997) The prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in two large American Midwest metropolitan hospital populations. Skeletal Radiol 26:222–225. doi:10.1007/s002560050225 PubMed

128.

Whang PG, Goldberg G, Lawrence JP et al (2008) The management of spinal fractures in patients with ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis: a comparison of treatment methods and clinical outcomes. J Spinal Disord Tech (in press)

129.

Winkelstein BA, Myers BS (1997) The biomechanics of cervical spine injury and implications for injury prevention. Med Sci Sports Exerc 29:S246–S255. doi:10.1097/00005768-199707001-00007 PubMed

130.

Organization World Health (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Tech Rep Ser 894:1–253

131.

Wrobel CJ, Meyer W (2000) Diffuse idiopathic skeletal hyperostosis. J Neurosurg 93:341–342PubMed

132.

Wu CT, Lee ST (1998) Spinal epidural hematoma and ankylosing spondylitis: case report and review of the literature. J Trauma 44:558–561. doi:10.1097/00005373-199803000-00029 PubMedCrossRef

133.

Young JS, Cheshire JE, Pierce JA et al (1977) Cervical ankylosis with acute spinal cord injury. Paraplegia 15:133–146PubMed

Title: Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications
Authors: L. A. Westerveld
J. J. Verlaan
F. C. Oner
Publication date: 01-02-2009
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 2/2009
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-008-0764-0

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Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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