Surgical Experience of Neglected Lower Cervical Spine Fracture in Patient with Ankylosing Spondylitis

Jo, Dae Jean; Kim, Sung Min; Kim, Ki Tack; Seo, Eun-Min

doi:10.3340/jkns.2010.48.1.66

Cited by 9 publications

(7 citation statements)

References 19 publications

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“…Elderly patients with AS and acute fractures have been shown to have better results when treated surgically [ 4 ]. Caron et al [ 2 ], in their large retrospective review, showed a mortality rate of 51% in the nonoperative group versus 23% in the operative group with age >70 being a major risk factor.…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Device in Posterior Spinal Fusion for a High Risk Thoraculombar Fracture in Ankylosing Spondylitis

et al. 2014

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Fractures in ankylosing spondylitis (AS) are often difficult to treat and surgical treatment may be fraught with complications. We describe the use of a robotic-assisted device in the surgical treatment of an unstable L1 fracture in an elderly patient with chronic lymphocytic leukemia and AS. The postoperative course was uneventful and the patient was discharged after 3 days. The use of a robotic-assisted device in spine surgery is particularly indicated in difficult high risk cases.

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Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Device in Posterior Spinal Fusion for a High Risk Thoraculombar Fracture in Ankylosing Spondylitis

et al. 2014

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“…However, Powell et al [20] in 1989 suggested that the existence of even a single normal vertebral body between the fractured vertebrae could be considered as a noncontinuous multiple vertebral fracture. The incidence of noncontinuous multiple vertebral fractures has been reported to range from 1.6% to 16.7% [7,8,23].…”

Section: Discussionmentioning

confidence: 99%

“…In patients with noncontinuous multiple vertebrae fractures, the primary fracture site is easily diagnosed clinically and radiologically, but the diagnosis of secondary fractures often tends to be delayed. According to some reports, it took 2.8 to 52.6 days to diagnose the secondary fracture site [8,13]. The reasons for the delayed diagnosis of other vertebral fractures are as follows [13,20].…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Treatment Outcomes of Acute Multiple Thoracic and Lumbar Spinal Fractures : A Comparison of Continuous and Noncontinuous Fractures

Cho

Kim

2019

J Korean Neurosurg Soc

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ObjectiveThe treatment of multiple thoracolumbar spine fractures according to fracture continuity has rarely been reported. Herein we evaluate the clinical features and outcomes of multiple thoracolumbar fractures depending on continuous or noncontinuous status. MethodsFrom January 2010 to January 2016, 48 patients with acute thoracic and lumbar multiple fractures who underwent posterior fusion surgery were evaluated. Patients were divided into two groups (group A : continuous; group B : noncontinuous). We investigated the causes of the injuries, the locations of the injuries, the range of fusion levels, and the functional outcomes based on the patients’ general characteristics. ResultsA total of 48 patients were enrolled (group A : 25 patients; group B : 23 patients). Both groups had similar pre-surgical clinical and radiologic features. The fusion level included three segments (group A : 4; group B : 5) or four segments (group A : 19; group B : 5). Group B required more instrumented segments than did group A. Group A scored 23.5 and group B scored 33.4 on the Korean Oswestry Disability Index (KODI) at the time of last follow-up. In both groups, longer fusion was associated with worse KODI score. ConclusionIn this study, due to the assumption of similar initial clinical and radiologic features in both group, the mechanism of multiple fractures is presumed to be the same between continuous and noncontinuous fractures. The noncontinuous fracture group had worse KODI scores in long-term follow-up, thought to be due to long fusion level. Therefore, we recommend minimizing the number of segments that are fused in multiple thoracolumbar and lumbar fractures when decompression is not necessary.

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“…Of note, these conservative treatments were associated with significant problems: risk of skin ulcerations, local septic, and respiratory problems, worsening of the regional kyphosis with loss of reduction, risk of non-union because of the shearing forces on the fracture site [19], and risk of neurological aggravation [20]. Overall, we suggest that conservative treatment only may not be suitable for this kind of fracture, particularly, in patients with severe neurological symptoms and unstable patterns such as type III and subtypes B and C. Furthermore, we strongly recommend surgery for a cervical fracture in AS, which is presently widely used [11,[21][22][23][24][25][26]]. e procedures had been described including anterior approach, posterior approach, and combined approach, and the surgical procedures in relation to classification were analyzed as described below.…”

Section: Choice Of Treatment Related To Different Fracturementioning

confidence: 94%

Classification and Treatment for Cervical Spine Fracture with Ankylosing Spondylitis: A Clinical Nomogram Prediction Study

Shen

Guo

et al. 2022

Pain Research and Management

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Objective. Through the follow-up analysis of cervical spine fracture cases with ankylosing spondylitis (AS), a treatment-oriented fracture classification method is introduced to evaluate the clinical efficacy guided by this classification method. Method. A retrospective analysis was performed on 128 AS patients who underwent comprehensive treatment in the Spine Surgery Department of Qingdao University Hospital from January 2009 to May 2018. Statistics of patient demographic data, distribution of different fractures corresponding to surgical methods, 3-year follow-up outcomes, and summary of objective fracture classification methods were analyzed. A prospective 5-year follow-up study of 90 patients with AS cervical spine fractures from June 2015 to August 2020 was also included. Statistical differences on the distribution of factors such as case information, cervical spine sagittal sequence parameters, and fracture classification were assessed. Correlations between surgical information, American Spinal Injuries Association grade (ASIA), modified Japanese Orthopaedic Association scores (mJOA), and other factors were analyzed to establish a nomogram predictive model for curative effect outcomes. Overall, three major types and the four subtypes of AS cervical spine fractures were evaluated based on the clinical efficacy of the classification and the selection of surgical treatment methods. Result. The most common type of fracture was type II (30 cases, 33.33%), most of the subtypes were A (37 cases), followed by B (36 cases) and C (17 cases). Twenty-four of 28 patients with type I underwent anterior surgery, and 47 of 62 patients with type II and III underwent posterior surgery. The average follow-up time was 25.76 ± 11.80 months. The results of predicting clinical variables are different but include factors such as fracture type and subtype, type of operation, and age. The predictor variables include the above-mentioned similar variables, but survival is more affected by the fracture type of the patient. Conclusion. This predictive model based on follow-up information delineation points out the impact of ankylosing spondylitis cervical spine fracture classification on surgical selection and clinical efficacy.

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Surgical Experience of Neglected Lower Cervical Spine Fracture in Patient with Ankylosing Spondylitis

Cited by 9 publications

References 19 publications

Robotic-Assisted Device in Posterior Spinal Fusion for a High Risk Thoraculombar Fracture in Ankylosing Spondylitis

Robotic-Assisted Device in Posterior Spinal Fusion for a High Risk Thoraculombar Fracture in Ankylosing Spondylitis

Clinical Features and Treatment Outcomes of Acute Multiple Thoracic and Lumbar Spinal Fractures : A Comparison of Continuous and Noncontinuous Fractures

Classification and Treatment for Cervical Spine Fracture with Ankylosing Spondylitis: A Clinical Nomogram Prediction Study

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