Destructive lesions of vertebral bodies in ankylosing spondylitis.

Cawley, M. I. D.; Chalmers, T. M.; Kellgren, Jan; Ball, J.

doi:10.1136/ard.31.5.345

Cited by 156 publications

(81 citation statements)

References 10 publications

(15 reference statements)

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“…Unless there is a trauma with acute new back pain, spinal fracture in these patients may be easily overlooked. Because of the presence of a chronic problem, the patients and physicians might not be aware of a new pathology-pseudoarthrosis (AL) [4,18,19].…”

Section: Discussionmentioning

confidence: 99%

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Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

2011

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This study reviews the presentation, etiology, imaging characteristics and reasons for missed diagnosis of Andersson lesion (AL) and analyzes the surgical results of short segment fixation in the thoracolumbar region. This is a retrospective single center study. Fourteen patients (15 lesions) who were operated for AL were analyzed. The study was designed in two parts. The first part consisted of analysis of clinical and radiological features (MRI and radiographs) to highlight, whether definitive characteristics exist. The second part consisted of analysis of outcome of short segment fixation as measured by VAS, Frankel score, AsQoL index, and union, with assessment of complications. The follow-up was 42.33 ± 19.29 months (13 males and 1 female) with a mean age of 61.13 ± 19.74 years. There was predisposing trauma in five patients. There was a delay in presentation of the patients by 5.86 ± 2.50 months. There was misdiagnosis in all the cases, at primary orthopedic level (ten cases were put on anti-tuberculous treatment due to its MRI resemblance to infection) and all but one case at radiologist level. Radiographs and MRI had characteristic features in all cases, and MRI could detect posterior element affection in 14 lesions as against only 8 posterior lesions detected in radiographs. In all patients, there was a patient's delay and/or physician's delay to arrive at a diagnosis. Spinal fusion was seen in all the cases. Outcome measures of VAS, Frankel score, and AsQoL index showed significant improvement (P \ 0.002). No major complications occurred. There is a lack of awareness of AL leading to misdiagnosis. Definite clinico-radiological features do exist in AL and short segment fixation is effective.

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Section: Discussionmentioning

confidence: 99%

“…and Cawley et al have attempted to classify inflammatory and non-inflammatory AL [14,18]. The radiographs show destructive transdiscal/transvertebral lesion, irregular margins with sclerosis, reduction in space, local kyphosis, posterior element break and generalized changes of bamboo spine with syndesmophytes [1,2,19].…”

Section: Discussionmentioning

confidence: 99%

Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

2011

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“…As a result of persistent motion at the fracture site, the healing process stops and the bone fails to unite, which leads to pseudarthrosis [12]. Spinal pseudarthrosiscomplicating AS is currently known as an Andersson lesion (AL) [4,5,7,11]. In addition, an AL may result in a localized progressive painful kyphotic deformity that leads to considerable disturbances of posture and sagittal balance.…”

Section: Introductionmentioning

confidence: 99%

Transpedicular wedge resection osteotomy for the treatment of a kyphotic Andersson lesion-complicating ankylosing spondylitis

et al. 2005

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“…15,47 Lesions that progress to ankylosis feature fibrous tissue, cartilage, and reactive bone formation. 7 More recent work by François et al 19 has shown that inflammation in the subchondral areas of the bone marrow precedes the findings of enthesitis described earlier.…”

Section: Histological Features Of Inflammatory Lesionsmentioning

confidence: 82%

Complications of the spine in ankylosing spondylitis with a focus on deformity correction

Mundwiler

Siddique

Dym

et al. 2008

FOC

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Destructive lesions of vertebral bodies in ankylosing spondylitis.

Cited by 156 publications

References 10 publications

Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation

Transpedicular wedge resection osteotomy for the treatment of a kyphotic Andersson lesion-complicating ankylosing spondylitis

Complications of the spine in ankylosing spondylitis with a focus on deformity correction

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