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. 2023 Aug;17(4):526-533.
doi: 10.14444/8478. Epub 2023 Jun 2.

Minimally Invasive Surgery for Thoracolumbar Spinal Fractures in Patients With Ankylosing Spondylitis

Johan Wänman  1 , Fabian Burmeister  2 , David Thorell  2 , Tobias Kyrk  2 , Simon Blixt  3 , Paul Gerdhem  3   4   5 , Sebastian Mukka  2 , Lukas Bobinski  2
Affiliations

Minimally Invasive Surgery for Thoracolumbar Spinal Fractures in Patients With Ankylosing Spondylitis

Johan Wänman et al. Int J Spine Surg. 2023 Aug.

Abstract

Background: Patients with ankylosing spondylitis (AS) are prone to spinal fractures even after low-energy trauma. Posterior fusion through open surgery has been the standard procedure for spinal fractures in patients with AS. Minimally invasive surgery (MIS) has been proposed as an alternative treatment option. There are few literature reports regarding patients with AS being treated for spinal fractures with MIS. This study aims to present the clinical outcome of a series of patients with AS treated with MIS for spinal fractures.

Methods: We included a consecutive series of patients with AS who underwent MIS for thoracolumbar fractures between 2014 and 2021. The median follow-up was 38 (12-75) months. Medical records and radiographs were reviewed, and data on surgery, reoperations, complications, fracture healing, and mortality were recorded.

Results: Forty-three patients (39 [91%] men) were included with a median (range) age of 73 (38-89) years. All patients underwent image-guided MIS with screws and rods. Three patients underwent reoperations, all due to wound infections. One patient (2%) died within 30 days and 7 (16%) died within the first year after surgery. Most patients with a radiographic follow-up of 12 months or more (29/30) healed with a bony fusion on computed tomography (97%).

Conclusion: Patients with AS and a spinal fracture are at risk of reoperation and have significant mortality during the first year. MIS provides adequate surgical stability for fracture healing with an acceptable number of complications and is an adequate choice in treating AS-related spinal fractures.

Keywords: ankylosing spondylitis; minimally invasive surgery; thoracolumbar fractures.

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Conflict of interest statement

Declaration of Conflicting Interests : The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart of patients. AS, ankylosing spondylitis; DISH, diffuse idiopathic skeletal hyperostosis; MIS, minimally invasive surgery; SI, sacroiliac.
Figure 2
Figure 2
Preoperative and 1 y postoperative computed tomographic images.
See this image and copyright information in PMC

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