Ankylosierende Spondylitis

Abstract

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

Surgical Treatment of Lumbar Hyperextension Injury in Ankylosing Spondylitis

“…Isolated anterior stabilizations are rarely indicated15). The frequently recommended posterior instrumentation results in higher stability opposed to the single ventral stabilization20). The combined posterior-anterior or anterior-posterior stabilizations are recommended due to resulting higher primary stability13,15).…”

“…Generally, surgical treatment in prone position of spinal fractures can help to reduce the danger of neurological deterioration and allow a first reduction and stabilization in a safe way20). But patients with AS are at increased risk for posture deterioration and iatrogenic fractures of the spine during the surgical procedure, especially while under sedation and anesthesia11).…”

“…Resulting kyphosis, spinal rigidity and secondary osteoporosis lead to changes of the biomechanical characteristics of the spinal column6,10). Secondary to kyphosis, the ventral displacement creates pathological tension and shearing forces to a spine with lacking flexibility20). Furthermore, the reduced muscle activity and increased muscle degeneration causes an overall loss of muscle strength18).…”

Analysis of the Literature on Cervical Spine Fractures in Ankylosing Spinal Disorders

“… 1 These ossifications entail bridging bone formations (syndesmophytes) in the spinal segments involved, with a high susceptibility to trauma even after low-energy impacts. 1 – 5 This is a result of long ankylosed lever arms combined with a reduced capability for deformation, resulting in unstable spinal fractures, especially in the lower cervical segments. 6 , 7 The most common entities involved in ASDs are ankylosing spondylitis (AS; also known as Bechterew disease) and diffuse idiopathic skeletal hyperostosis (DISH; also known as Forestier disease).…”

“… 2 , 7 The cervical spine is the region that is most susceptible to these fractures. 2 – 4 , 22 The reason for this may be the hypermobility of the cervical spine in combination with the weight of the skull, small vertebral bodies, and the position of the cervical facet joints. 23 , 24 In addition, patients suffering from AS frequently present with concomitant osteoporosis, especially in the early stages of the disease.…”