Ankylosing spondylitis and spinal cord injury: origin, incidence, management, and avoidance

Jacobs, W. Bradley; Fehlings, Michael G.

doi:10.3171/foc/2008/24/1/e12

Cited by 137 publications

(123 citation statements)

References 40 publications

(48 reference statements)

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“…There is data suggesting that patients with AS have an increased rate of spinal cord injuries (SCIs), [24][25][26] which is directly correlated with the increased incidence of vertebral fractures and fracture risk that is associated with the risk of falling and osteoporosis in AS patients. [24] Hence, understanding the impact of AS on fall risk and determining which clinical features are associated with this risk should be an important goal for healthcare professionals involved in the treatment of AS patients.…”

Section: Discussionmentioning

confidence: 99%

Fall Risk in Patients with Ankylosing Spondylitis

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Fall Risk in Patients with Ankylosing Spondylitis

et al. 2013

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“…This contributes to four to five times increased frequency of spinal fractures in them as compared with the general population. 1 Currently, surgery is the preferred method to stabilize these injuries to promote early mobility and prevent chest complications. However, they have increased tendency to experience postoperative complications as evident from published western studies, because of extensive restrictive lung disease, other comorbidities and complexity of the surgical procedure itself.…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of spinal trauma in patients with ankylosing spondylitis: a descriptive study in Indian population

et al. 2014

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Objective: This study aims to understand the demographics, mode of trauma, hospital stay, complications, neurological improvement, mortality and expenditure incurred by Indian patients with spinal trauma and ankylosing spondylitis (AS). Methods: Retrospective analysis of the patient data admitted to a tertiary referral hospital from 2008 to 2013 with the diagnosis of AS and spinal trauma was carried out. The variables studied were demographics, mode of trauma, neurological status, neurological improvement, involved vertebral level, duration of hospital stay, comorbid factors, expenditure and complications during the stay. Results: Forty-six patients with diagnosis of AS with spine trauma were admitted over the last 5 years with a total of 52 fractures. All were male patients; 58.6% had injury because of trivial trauma and 78.2% patients presented with neurological injury. C5 C6, C6 C7, C7 D1 and D12 were the most common injured level. Fractures through intervertebral disc were most common in cervical spine. Of the patients, 52.7% had shown neurological improvement of at least grade 1(AIS). Mean expenditure of patient admitted with spinal cord injury (SCI) with AS is 7957 USD (United States dollar), which is around five times the per capita income in India (as per year 2013). Conclusion: Males with AS are much more prone to spinal fractures than females and its incidence may be higher than previously reported. Domestic falls are the most common mechanism of spinal trauma in this population. High velocity injuries are associated with complete SCI. The study reinforces the need for development of subsidized spinal care services for SCI management.

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“…There appears to be a genetic relation to HLA-B27; AS is seen in 90-95% of HLA-B27 patients, whereas only 1-5% of individuals who are HLA-B27 positive develop the disease. The influence of other environmental factors in this condition has been hypothesized [6,7].…”

Section: Introductionmentioning

confidence: 99%

Comparison of three types of lumbar osteotomy for ankylosing spondylitis: a case series and evolution of a safe technique for instrumented reduction

2011

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Introduction The principles of correction of thoracolumbar kyphotic deformity (TKLD) in ankylosing spondylitis (AS) are essentially centred on lordosing osteotomies such as pedicle subtraction closing wedge osteotomy (CWO), polysegmental posterior lumbar wedge osteotomies (PWO) and Smith Peterson's open wedge osteotomy (OWO) of the lumbar spine. There have been no studies that compared the results of the three osteotomies performed by a single surgeon with a long-term follow-up. Materials and Methods A retrospective review of 31 patients with AS was performed: 12 patients underwent CWO, 10 had OWO, and 9 had PWO. Radiographic assessment was performed at 6, 12, 24, and 52 weeks and annually thereafter. Clinical assessment included blood loss, intensive care unit (ICU) stay, and surgical time recordings. All patients were assessed clinically at regular intervals and outcome measures recorded included Oswestry Disability Index (ODI), Visual Analogue Score (VAS) for pain, and SRS-22 (recorded in 23 patients).Results The mean age at surgery was 54.7 years (40-74 years) and mean duration of symptoms was 3 years (range, 5-8 years). Mean follow-up was 5 years (range, 2-10 years). There was no statistically significant difference between the three techniques with regard to mean duration of surgery and ICU stay. The mean duration of surgery was 7 h (range, 4-9 h) (OWO cases had shorter period than CWO and PWO cases, and the longest period was for CWO cases). The mean ICU stay was 3 days (range, 2-20 days) (the period of stay was shorter in general for OWO and slightly longer for CWO and PWO). Blood loss was expressed as percentage of estimated blood volume (EBV). The mean blood loss in PWO was 23 ± 15.4% (range, 9-36%), CWO was 28 ± 4.5% (range, 12-40%) and in OWO was 15 ± 11% (range, 13-99%). Mean correction of kyphosis was 38°(range, 25°-49°) with CWO, 28°with OWO (range, 24°-38°) and 30°with PWO (range, 28°-40°). In comparison to preoperative scores, statistically significant improvement was noted in all three groups in the postoperative period with regard to ODI, VAS and SRS-22 (p = 0.001, Wilcoxon signed-rank test). Conclusion Better radiographic correction was noted in the CWO and PWO groups, although this was associated with increased blood loss, multiple levels of instrumentation, and increased surgical time compared to OWO. A new safe technique of instrumentation using temporary malleable rods to prevent sagittal translation during the reduction manoeuvre is also described.

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Ankylosing spondylitis and spinal cord injury: origin, incidence, management, and avoidance

Cited by 137 publications

References 40 publications

Fall Risk in Patients with Ankylosing Spondylitis

Fall Risk in Patients with Ankylosing Spondylitis

Retrospective analysis of spinal trauma in patients with ankylosing spondylitis: a descriptive study in Indian population

Comparison of three types of lumbar osteotomy for ankylosing spondylitis: a case series and evolution of a safe technique for instrumented reduction

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