Wirbelsäulenfraktur bei ankylosierender Spondylitis View Full Text


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Article Info

DATE

2011-06-19

AUTHORS

M. Backhaus, M. Citak, T. Kälicke, R. Sobottke, O. Russe, R. Meindl, G. Muhr, T.M. Frangen

ABSTRACT

IntroductionThe ankylosing spondylitis (AS) is a systemic rheumatic disease, which affects the skeleton, joints and internal organs. Attributed to the augmented rigidity of the spine and the concomitant impairment of compensatory mechanism minor force might cause spine fractures. Multilevel stabilization and dorsoventral instrumentation is a well – established procedure. This study was to evaluate the surgical outcome of 119 patients with AS associated spine fractures.MethodsFrom 07/96 to 01/10, 119 patients with 129 spine fractures due to AS were treated in our department. Data were collected retrospectively. In all patients the operative treatment of the fracture was either performed by ventral and/or dorsal spondylodesis.ResultsThe median age was 67 years (37–95). There were 51 cervical, 55 thoracic and 23 lumbar spine fractures. On initial presentation no fractures in 18 patients (15%) and stable fractures in 15 patients (13%) were detected, which further secondarily dislocated. Thus, in 28% of the patients the injury was assessed falsely. 47% of the fractures were preceded by a trivial trauma in domestic surrounding. 61 patients (51%) developed either an incomplete or a complete paraplegia. In 32 patients ventral instrumentation, in 82 patients dorsal and in 15 patients dorsoventral instrumentation were performed. 14% developed postoperative wound infection an in 15% revision surgery due to implant loosening or insufficient stabilization was required.ConclusionEarly diagnostic of AS associated spine fractures using conventional radiographs and computed tomography scans is important for the detection and adequate treatment. A great amount of spine fractures are obviously either under diagnosed or underestimated, initially. A secondary dislocation of the fracture might result in severe neurological complications up to paraplegia. More... »

PAGES

917

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00132-011-1792-8

DOI

http://dx.doi.org/10.1007/s00132-011-1792-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1042465289

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/21688056


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36 schema:description IntroductionThe ankylosing spondylitis (AS) is a systemic rheumatic disease, which affects the skeleton, joints and internal organs. Attributed to the augmented rigidity of the spine and the concomitant impairment of compensatory mechanism minor force might cause spine fractures. Multilevel stabilization and dorsoventral instrumentation is a well – established procedure. This study was to evaluate the surgical outcome of 119 patients with AS associated spine fractures.MethodsFrom 07/96 to 01/10, 119 patients with 129 spine fractures due to AS were treated in our department. Data were collected retrospectively. In all patients the operative treatment of the fracture was either performed by ventral and/or dorsal spondylodesis.ResultsThe median age was 67 years (37–95). There were 51 cervical, 55 thoracic and 23 lumbar spine fractures. On initial presentation no fractures in 18 patients (15%) and stable fractures in 15 patients (13%) were detected, which further secondarily dislocated. Thus, in 28% of the patients the injury was assessed falsely. 47% of the fractures were preceded by a trivial trauma in domestic surrounding. 61 patients (51%) developed either an incomplete or a complete paraplegia. In 32 patients ventral instrumentation, in 82 patients dorsal and in 15 patients dorsoventral instrumentation were performed. 14% developed postoperative wound infection an in 15% revision surgery due to implant loosening or insufficient stabilization was required.ConclusionEarly diagnostic of AS associated spine fractures using conventional radiographs and computed tomography scans is important for the detection and adequate treatment. A great amount of spine fractures are obviously either under diagnosed or underestimated, initially. A secondary dislocation of the fracture might result in severe neurological complications up to paraplegia.
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44 ConclusionEarly
45 Department
46 MethodsFrom 07/96
47 Wirbelsäulenfraktur bei ankylosierender Spondylitis
48 adequate treatment
49 age
50 amount
51 ankylosierender Spondylitis
52 bei ankylosierender Spondylitis
53 compensatory mechanism minor force
54 complete paraplegia
55 complications
56 concomitant impairment
57 conventional radiographs
58 data
59 detection
60 disease
61 dislocations
62 domestic surroundings
63 dorsal
64 dorsal spondylodesis
65 dorsoventral instrumentation
66 force
67 fractures
68 greater amount
69 impairment
70 implant loosening
71 infection
72 initial presentation
73 injury
74 instrumentation
75 insufficient stabilization
76 internal organs
77 joints
78 loosening
79 lumbar spine fractures
80 mechanism minor force
81 median age
82 minor force
83 multilevel stabilization
84 neurological complications
85 operative treatment
86 organs
87 outcomes
88 paraplegia
89 patients
90 patients dorsal
91 patients dorsoventral instrumentation
92 patients ventral instrumentation
93 postoperative wound infection
94 presentation
95 procedure
96 radiographs
97 revision surgery
98 rheumatic diseases
99 rigidity
100 scans
101 secondary dislocations
102 severe neurological complications
103 skeleton
104 spine
105 spine fractures
106 spondylitis
107 spondylodesis
108 stabilization
109 stable fractures
110 study
111 surgery
112 surgical outcomes
113 surroundings
114 systemic rheumatic diseases
115 thoracic
116 tomography scan
117 trauma
118 treatment
119 trivial trauma
120 ventral instrumentation
121 wound infection
122 years
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