Abstract
Introduction: We present single-centre, retrospective study of patients with ankylosing spondylitis, treated for spinal fractures. In this group of, the issues of diagnosis, mechanism of injury, neurological findings and the type of fracture have been evaluated.
Treatment strategies, complexity and development of neurological findings are evaluated in detail. Material and methods: Eight men were treated at the Orthopaedic Clinic of the Bulovka Hospital from January 2010 to December 2014, with an average age of 63 years.
Fractures of the cervical spine, especially in subaxial localization C6/7 were the most prevalent, with a total of three patients, after that, fractures in the thoracic-lumbar transition of the spine was found in two patients. The other patients were diagnosed with 1x fracture in the Dent C2, 1x thoracic spine fracture Th and 1x 5/6 fracture of the lumbar spine L3/4th.
A total of five patients were treated with posterior repositioning, instrumentation and fusion, only one patient with a fracture of the C6/7 with minimal kyphotic deformity was treated using anterior approach, deliberation and spondylodesis. A total of two patients were treated conservatively.
Results: Three patients (37.5%) were diagnosed with a delay and in two cases, neurological deficit developed in this interval. From acute surgical complications, superficial infection was observed in one case, screw malposition in posterior instrumentation two times and there was one case of bronchopneumonia in the early postoperative period.
No patient's neurological condition worsened postoperatively. Discussion: In the treatment of unstable fractures we prefer surgical therapy.
We are using posterior surgical approach with dorsal instrumentation with at least two segments above and below the fracture.