Author/Editor		Štraus, Ivan; Vesel, Miloš; Jug, Marko; Dobravec, Marko
Title		Zlomi hrbtenice pri morbus Bechterew
Translated title		Spine fractures in ankylosing spondylitis
Type		članek
Source		In: Komadina R, Stahovnik A, editors. 5. Celjski dnevi. Zbornik izbranih predavanj simpozija o poškodbah in okvarah hrbtenice; 2005 apr 8-9; Celje. Celje: Splošna bolnišnica Celje,
Publication year		2005
Volume		str. 155-9
Language		slo
Abstract		Ankylosing spondylitis (Mb. Bechterew) is a chronic inflammatory joint disease in which inflammation of the entheses gradually causes local ossification and ankylosis. In this clinical review we emphasize the fragility of the ankylosed spine and the degree of neurological deficit that can result from minor injury. The management of spinal fractures complicating ankylosing spondylitis is discussed. METHODS AND RESULTS: 37 spinal fractures were identified in a review of trauma patients with ankylosing spondylitis on the last 15 years. 17 fractures affected the cervical, 10 the thoracic and 10 the lumbar spine. The majority of fractures were associated wifh an extension deformity. The mean age in patients suffering fractures after minor traumatic injury was more than 60 years, whereas patients suffering fracfures after major traumatic injury were 10 years younger in average. 13 patients were treated with bedrest and brace therapy, and 24 underwent operative stabilisation. Conservative treatment was predilected in patients with thoracic spine fractures, where the chest itself offered additional stability, and in all patients that could not have been operated because of their poor general condition. Postinjury neurological deficits were demonstrated in 16 patients. In all partial lesions of the spinal cord neurological improvement was observed. CONCLUSIONS: Patients with ankylosing spondylitis are at risk of spinal injury, particularly extension fractures. The high incidence of trauma-induced neurological deficit and redislocation requires special attention and diagnostics for any suspected injury Management consists of surgery in patients with vertebral instability and neural compression, and recumbency in those with stable fractures, particulary in the thoracic region. However, because of the difficult management and the high incidence of complications such patients must be treated in specialized centers.
Descriptors		SPONDYLITIS, ANKYLOSING SPINAL FRACTURES