title: Spinal Fractures in Patients With Ankylosing Spondylitis: Etiology, Diagnosis, and Management.
abstract: In patients with ankylosing spondylitis, the altered biomechanics of the spine increase the incidence of spinal fractures and the risk of subsequent displacement and neurologic injury. Radiographic evaluation is difficult and requires imaging of the entire spine and the use of advanced imaging. Nonsurgical treatment has a high rate of complications and is typically pursued only when surgical intervention would carry unacceptably high perioperative risks. The surgical approach depends on the fracture location and any deformity present. Anterior fixation alone has been associated with high failure rates; therefore, posterior or combined anterior-posterior fixation should be considered. With either nonsurgical or surgical management, complications are frequent and can result in high mortality rates; however, good outcomes can be achieved if an appropriate level of suspicion of fracture is maintained and care is taken to avoid complications related to patient transport, transfer, and positioning.
authors.affiliation: From the Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA (Dr. Werner and Dr. Shen), and the Department of Orthopaedics and Traumatology, University of Hong Kong, Pok Fu Lam, Hong Kong (Dr. Samartzis).
authors.forename: Brian C
authors.initials: BC
authors.lastname: Werner
authors.forename: Dino
authors.initials: D
authors.lastname: Samartzis
authors.forename: Francis H
authors.initials: FH
authors.lastname: Shen
mesh_terms: D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D016103:Spinal Fractures / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000503:physiopathology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome