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  4. Spine and Spinal Cord Injury Associated with a Fracture in Elderly Patients with Ankylosing Spondylitis

Spine and Spinal Cord Injury Associated with a Fracture in Elderly Patients with Ankylosing Spondylitis

Neurol Med Chir (Tokyo), 2018 · DOI: 10.2176/nmc.oa.2017-0112 · Published: March 1, 2018

Spinal Cord InjuryAgingNeurology

Simple Explanation

This study examines spinal cord injuries in elderly individuals who also have ankylosing spondylitis (AS), a condition causing spine stiffness. The research focuses on how fractures in the spine affect these patients. Researchers analyzed the types of injuries, treatment methods (surgery vs. brace), and how patients recovered. The goal was to find the best ways to manage these complex cases. The study found that while surgery didn't always improve neurological status, it could help prevent other complications like pneumonia. Therefore, early surgery and rehabilitation are recommended for these patients.

Study Duration
2008-2015
Participants
9 elderly patients with spinal cord injury and vertebral fractures in ankylosed spines
Evidence Level
Not specified

Key Findings

  • 1
    The most common injury mechanism was a fall, and the cervical spine was the most frequent fracture location.
  • 2
    There was no significant difference in neurological outcomes between surgical and conservative (brace) treatments.
  • 3
    Early surgical intervention may be beneficial in preventing pulmonary complications, regardless of neurological improvement.

Research Summary

This study investigated the clinical results of spinal cord injury with a fracture in elderly patients with ankylosing spondylitis (AS). Nine patients with spinal cord injury and vertebral fractures in ankylosed spines were included. The mechanism of injury, fracture levels, clinical methods, follow-up period, and treatment outcomes were analyzed. The study suggests that while neurological outcomes may not differ significantly between surgical and conservative treatments, early surgical intervention and rehabilitation are recommended to prevent further complications.

Practical Implications

Comprehensive Spine Evaluation

In patients with AS and suspected spinal fracture, CT imaging of the entire spine is crucial for accurate diagnosis.

Early Surgical Intervention

Consider early surgical intervention and rehabilitation to prevent pulmonary complications, even if neurological improvement is not guaranteed.

Individualized Treatment Plans

Treatment should be tailored to the patient's condition, considering fracture level, spinal cord compression, and overall health.

Study Limitations

  • 1
    Small sample size (9 patients).
  • 2
    Retrospective study design.
  • 3
    Not all patients were diagnosed with AS before the injury

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