Clinical outcome after traumatic spinal fractures in patients with ankylosing spinal disorders compared with control patients

Westerveld, L. A.; Bemmel, J.C. van; Dhert, Wouter J.A.; Öner, F. Cumhur; Verlaan, Jorrit‐Jan

doi:10.1016/j.spinee.2013.06.038

Cited by 162 publications

(160 citation statements)

References 38 publications

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“…14,15 Falls were suggested as the most common causes of spinal fractures which resulted in higher morbidity and mortality in subjects with AS when compared to those without AS. 6 Thus, postural assessment is crucial to predict and prevent balance disorders and falls in AS patients.…”

Section: Discussionmentioning

confidence: 99%

“…Previously, only static or dynamic balance were assessed in AS patients. [5][6][7] However, we were unable to detect any trial in the literature assessing both static and dynamic balance in AS patients. Therefore, factors affecting balance in AS patients are still unclear.…”

mentioning

confidence: 83%

“…It has been reported that spinal fractures resulted in higher morbidity and mortality in AS patients when compared to those in healthy subjects. 6 Further disabilities and falls may be avoided by understanding the factors affecting balance in AS patients. Previously, only static or dynamic balance were assessed in AS patients.…”

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confidence: 99%

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What Impairs Balance in Ankylosing Spondylitis? Posture or Disease Activity?

et al. 2017

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Objectives:This study aims to compare ankylosing spondylitis (AS) patients with healthy subjects in terms of posture and balance, and to identify the factors correlated with balance in AS. Patients and methods: Thirty patients (17 males, 13 females; mean age 41.7±7.7 years; range 31 to 57 years) with AS and 33 healthy subjects (18 males, 15 females; mean age 41.3±7.0 years; range 26 to 56 years) were included in the study. Participants were assessed in terms of posture and balance. Posture was assessed using tragus-wall distance, modified Schober's test, and chest expansion. Balance was assessed using device-assisted balance tests. Pain (visual analog scale) and disease activity (Bath Ankylosing Spondylitis Disease Activity Index) were assessed only in AS patients. Results: Ankylosing spondylitis patients walked more slowly when compared to healthy subjects (p=0.002). As the modified Schober's test was restricted, AS patients had greater step width in tandem walk and higher sway velocity on foam base (r=-0.418 p=0.022; r=-0.473 p=0.008). Neither Bath Ankylosing Spondylitis Disease Activity Index nor visual analog scale was correlated with balance. Conclusion: Static and dynamic balance are impaired in AS patients when compared to healthy subjects. Restricted mobility of the spine and advanced kyphosis impaired balance, while pain and disease activity had no correlations with balance.

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Section: Discussionmentioning

confidence: 99%

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confidence: 83%

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What Impairs Balance in Ankylosing Spondylitis? Posture or Disease Activity?

et al. 2017

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“…Absence of adequate follow-up data was considered 19 the most significant weakness of the majority of the related papers. Hong 45 followed up a group of eight subjects, from 4 up to 38 months (an average of 34 months) and noticed improvements of different degrees after operation, in five of them.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16][17] In about two third of the cases, the main etiology consists of falls from standing or sitting position, the cervical region being the most frequently injured (in about 81% cases). 18,19 SUBJECTS AND METHODS This observational study aims to depict the clinical profile and functional outcomes of patients with AS who suffered a spinal cord injury (AS-SCI), and to evaluate the incidence of AS-SCI among the cohort of all consecutive subjects with traumatic SCI, admitted in a Romanian rehabilitation clinic.…”

Section: Introductionmentioning

confidence: 99%

Evolution of traumatic spinal cord injury in patients with ankylosing spondylitis, in a Romanian rehabilitation clinic

Anghelescu

Onose²,

Popescu

et al. 2016

Spinal Cord Ser Cases

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The ankylosing spondylitis (AS) is a systemic, multi-factorial, chronic rheumatic disease. Patients are highly susceptible to vertebral fractures with or without spinal cord injury (AS-SCI), even after a minor trauma. The study is a retrospective descriptive survey of post-acute, traumatic AS-SCI patients, transferred from the neurosurgical department and admitted in a Romanian Neurorehabilitation Clinic, during 2010-2014. There were 11 males associating AS-SCI (0.90% of all consecutive SCI admitted cases), with an average age of 54.6 years (median 56, limits 42-73 years). The average duration between the medically diagnosed AS and the actual associated spinal fracture(-s) moment was 21.4 years (median 23; limits 10-34 years). Low-energy trauma was incriminated in 54.5% cases. The spinal level of fracture was: cervical (four cases), thoracic (three), lumbar (four), assessed at admission as: American Spinal Injury Association (ASIA) Impairment Scale (AIS) A (four subjects), C (five) and D (two). By the time of discharge, neither patient has neurologically deteriorated; five patients (45.5%) improved of at least grade 1 (AIS). The overall complications were mainly infections: symptomatic urinary tract infections (seven patients; 63.6%), pulmonary (three subjects; 27.3%) and spondylodiscitis (one case; 9%). The average follow-up period was 15.3 months (median 12; limits 1-48 months) after discharge; three subjects gained functional improvement to AIS-E. The clinical profile (different risk factors, mechanisms, types and levels of spinal fractures, additional encephalic and/or cord lesions, co-morbidities), different post-surgical and/or general complications acquired during admission in our rehabilitation ward, served us for future prevention strategies and a better therapeutic management.

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Cervical Spinal Fracture and Other Diagnoses Associated With Mortality in Hospitalized Ankylosing Spondylitis Patients

Wysham

Murray

Hills

et al. 2017

Arthritis Care & Research

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Objective Little data exist regarding mortality in Ankylosing Spondylitis (AS). We assessed diagnoses associated with in-hospital mortality in AS using a population-based inpatient dataset. Methods Data were abstracted from the Healthcare Cost and Utilization Project- Nationwide Inpatient Sample (HCUP-NIS) between 2007–2011. We identified AS admissions using International Classification of Diseases-9 Clinical Modification (ICD9-CM) code 720.0. In-hospital mortality was the primary outcome. Logistic regression was used to evaluate the association between top diagnoses and in-hospital mortality. We performed a secondary analysis from the same years in all patients (with and without AS) with cervical spine (c-spine) fracture to determine whether AS was an independent risk factor for mortality. Results Between 2007–2011 we identified 12,484 admissions and 267 deaths in AS patients. C-spine fracture with spinal cord injury and sepsis had the highest odds (OR) of death, 13.43 (95% Confidence Interval (CI) 8.00–22.55; p<0.0001) and 7.63 (95% CI 5.62–10.36; p<0.0001) respectively. In the same time period, there were 53,606 C-spine fracture admissions of which 408 were coded with AS. Among all c-spine fracture hospitalizations, an AS diagnosis was associated with in-patient death (OR 1.61; 95% CI 1.16–2.22; p=0.004). Conclusion In AS patients admitted to the hospital, c-spine fracture is a leading cause of in-hospital mortality. Other diagnoses associated with mortality include sepsis, pneumonia, CVD and comorbid illnesses. Among all hospitalizations with c-spine fracture, AS was associated with an increased odds of death. C-spine fracture-associated mortality warrants further study to elucidate risk factors in order to prevent this devastating event in AS patients.

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Clinical outcome after traumatic spinal fractures in patients with ankylosing spinal disorders compared with control patients

Cited by 162 publications

References 38 publications

What Impairs Balance in Ankylosing Spondylitis? Posture or Disease Activity?

What Impairs Balance in Ankylosing Spondylitis? Posture or Disease Activity?

Evolution of traumatic spinal cord injury in patients with ankylosing spondylitis, in a Romanian rehabilitation clinic

Cervical Spinal Fracture and Other Diagnoses Associated With Mortality in Hospitalized Ankylosing Spondylitis Patients

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