title: A case report of neurologically unstable fracture of the lumbosacral spine in a patient with ankylosing spondylitis.
abstract: BACKGROUND
  Fracture/dislocation is uncommonly reported in ankylosing spondylitis involving the lumbosacral spine.
  
  
  METHODS
  We report an 18-month follow-up of a case of neurologically unstable traumatic fracture of the lumbosacral spine in ankylosing spondylitis.
  
  
  RESULTS
  Posterior decompression, alar-transverse fusion and instrumentation were performed. Anterior diskectomy and fusion were done 6 weeks later. There was solid bony fusion on follow-up and the patient had improvement of 2 Frankel grades and was able to ambulate.
  
  
  CONCLUSIONS
  Combined approaches and longer fixations to stabilise the spine may be required. In the lumbosacral spine, this poses a problem vis-à-vis limited levels of fixation in the sacrum.
authors.affiliation: Division of Spinal Surgery, Department of Orthopaedic Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. hwantak@singnet.com.sg
authors.forename: H T
authors.initials: HT
authors.lastname: Hee
authors.forename: J
authors.initials: J
authors.lastname: Thambiah
authors.forename: A
authors.initials: A
authors.lastname: Nather
authors.forename: H K
authors.initials: HK
authors.lastname: Wong
mesh_terms: D000058:Accidental Falls; D003131:Combined Modality Therapy; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012447:Sacrum / Q000293:injuries*; D013117:Spinal Cord Compression / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D016103:Spinal Fractures / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000175:diagnosis*; D016896:Treatment Outcome