Asian Spine J.  2018 Jun;12(3):434-441. 10.4184/asj.2018.12.3.434.

Surgical Outcomes of Minimally Invasive Stabilization for Spinal Fractures in Patients with Ankylosing Spinal Disorders

Affiliations
  • 1Department of Orthopedic Surgery, Japanese Red Cross Society Karatsu Red Cross Hospital, Karatsu, Japan. hiro_stylish.0305@me.com

Abstract

STUDY DESIGN: A retrospective study. PURPOSE: To evaluate the clinical and radiological outcomes of ankylosing spinal disorder (ASD) patients with spinal fractures treated by minimally invasive stabilization (MISt) using percutaneous pedicle screws (PPSs). OVERVIEW OF LITERATURE: ASDs, such as ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH), increase susceptibility to spinal fractures because of extremely decreased spinal flexibility. Such fractures tend to be unstable and, consequently, should be treated with multiple-segmental internal fixation. However, conventional internal fixation procedures can severely damage the soft tissue, resulting in severe hemorrhage. Therefore, MISt is the preferred approach to treat spinal fractures in ASD patients.
METHODS
Nine ASD patients (four males and five females; three AS and six DISH patients) with spinal fractures who were treated by MISt using PPSs, were reviewed from April 2009 to August 2016. One patient died of aspiration pneumonia during follow-up (FU), and the remaining eight patients underwent clinical and radiological evaluation.
RESULTS
The mean age at surgery was 79.6 years (range, 68-95 years). The mean duration of postoperative FU was 14.2 months (range, 3-30 months). All treated fractures were anterior and posterior element injuries with distraction. Three patients presented delayed onset preoperative neurological deficit following trauma. The mean operation time was 179.6 minutes (range, 92-340 minutes). The mean hemorrhage was 103.6 mL (range, unquantifiable to 480 mL). Radiological evaluations at FU showed preservation of the acceptable postoperative correction of the fractured vertebra, as there were no re-collapses of the fractured vertebrae during FU.
CONCLUSIONS
ASD patients must be acknowledged as highly susceptible to unstable spinal fractures, even after relatively mild trauma. MISt using PPSs may be an effective treatment for spinal fractures in such patients.

Keyword

Spondylarthritis; Ankylosing spondylitis; Diffuse idiopathic skeletal hyperostosis; Minimally invasive surgical procedures; Pedicle screws

MeSH Terms

Female
Follow-Up Studies
Hemorrhage
Humans
Hyperostosis, Diffuse Idiopathic Skeletal
Male
Minimally Invasive Surgical Procedures
Pedicle Screws
Pliability
Pneumonia, Aspiration
Retrospective Studies
Spinal Fractures*
Spine
Spondylarthritis
Spondylitis, Ankylosing
Full Text Links
  • ASJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr