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Spine Fractures of Patients with Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis: Fracture Severity and Injury-Related Mortality at a Level I Trauma Center

STUDY DESIGN: Retrospective review of prospectively collected cohort. PURPOSE: To identify differences in treatment and mortality of spine fractures in patients with ankylosing conditions of the spine. OVERVIEW OF LITERATURE: Ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (...

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Autores principales: Chen, Stephen Ryan, Munsch, Maria Amelia, Chen, Joseph, Couch, Brandon Keith, Wawrose, Richard Alan, Oyekan, Anthony Abimbade, Adjei, Joshua, Donaldson, William F., Lee, Joon Yung, Shaw, Jeremy DeWitt
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10300891/
https://www.ncbi.nlm.nih.gov/pubmed/36775833
http://dx.doi.org/10.31616/asj.2022.0155
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author Chen, Stephen Ryan
Munsch, Maria Amelia
Chen, Joseph
Couch, Brandon Keith
Wawrose, Richard Alan
Oyekan, Anthony Abimbade
Adjei, Joshua
Donaldson, William F.
Lee, Joon Yung
Shaw, Jeremy DeWitt
author_facet Chen, Stephen Ryan
Munsch, Maria Amelia
Chen, Joseph
Couch, Brandon Keith
Wawrose, Richard Alan
Oyekan, Anthony Abimbade
Adjei, Joshua
Donaldson, William F.
Lee, Joon Yung
Shaw, Jeremy DeWitt
author_sort Chen, Stephen Ryan
collection PubMed
description STUDY DESIGN: Retrospective review of prospectively collected cohort. PURPOSE: To identify differences in treatment and mortality of spine fractures in patients with ankylosing conditions of the spine. OVERVIEW OF LITERATURE: Ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) are the two most common etiologies of ankylosing spinal disorder (ASD). However, studies on the treatment and outcomes of spine fractures in AS and DISH patients remain few. METHODS: Patients presenting with a spine fracture were diagnosed with AS or DISH at a single tertiary care center between 2010 and 2019. We excluded those who lacked cross-sectional imaging or fractures occurring at spinal segments affected by ankylosis, as well as polytraumatized patients. Patient demographics, injury mechanism, fracture level, neurologic status, treatment, and 1-year mortality were recorded. Computed tomography imaging was reviewed by two independent readers and graded according to the indicated AO Spine Injury Classification System. Differences in fracture severity, treatment method, and mortality were examined using Student t-tests, chi-square tests, and two-proportion Z-tests with significance set to p<0.05. RESULTS: We identified 167 patients with spine fracture diagnosed with AS or DISH. Patients with AS had more severe fractures and more commonly had surgery than patients with DISH (p<0.001). Despite these differences, 1-year mortality did not significantly differ between AS and DISH patients (p=0.14). CONCLUSIONS: Although patients with AS suffered more severe fractures compared to DISH and more frequently underwent surgery for these injuries, outcomes and 1-year mortality did not differ significantly between the two groups. For patients with ASDs and fractures, outcomes appear similar regardless of treatment modality. Consequently, there may be an opportunity for critical reappraisal of operative indications in ASD and a larger role for nonoperative management in these challenging patients.
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spelling pubmed-103008912023-06-29 Spine Fractures of Patients with Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis: Fracture Severity and Injury-Related Mortality at a Level I Trauma Center Chen, Stephen Ryan Munsch, Maria Amelia Chen, Joseph Couch, Brandon Keith Wawrose, Richard Alan Oyekan, Anthony Abimbade Adjei, Joshua Donaldson, William F. Lee, Joon Yung Shaw, Jeremy DeWitt Asian Spine J Clinical Study STUDY DESIGN: Retrospective review of prospectively collected cohort. PURPOSE: To identify differences in treatment and mortality of spine fractures in patients with ankylosing conditions of the spine. OVERVIEW OF LITERATURE: Ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) are the two most common etiologies of ankylosing spinal disorder (ASD). However, studies on the treatment and outcomes of spine fractures in AS and DISH patients remain few. METHODS: Patients presenting with a spine fracture were diagnosed with AS or DISH at a single tertiary care center between 2010 and 2019. We excluded those who lacked cross-sectional imaging or fractures occurring at spinal segments affected by ankylosis, as well as polytraumatized patients. Patient demographics, injury mechanism, fracture level, neurologic status, treatment, and 1-year mortality were recorded. Computed tomography imaging was reviewed by two independent readers and graded according to the indicated AO Spine Injury Classification System. Differences in fracture severity, treatment method, and mortality were examined using Student t-tests, chi-square tests, and two-proportion Z-tests with significance set to p<0.05. RESULTS: We identified 167 patients with spine fracture diagnosed with AS or DISH. Patients with AS had more severe fractures and more commonly had surgery than patients with DISH (p<0.001). Despite these differences, 1-year mortality did not significantly differ between AS and DISH patients (p=0.14). CONCLUSIONS: Although patients with AS suffered more severe fractures compared to DISH and more frequently underwent surgery for these injuries, outcomes and 1-year mortality did not differ significantly between the two groups. For patients with ASDs and fractures, outcomes appear similar regardless of treatment modality. Consequently, there may be an opportunity for critical reappraisal of operative indications in ASD and a larger role for nonoperative management in these challenging patients. Korean Society of Spine Surgery 2023-06 2023-02-13 /pmc/articles/PMC10300891/ /pubmed/36775833 http://dx.doi.org/10.31616/asj.2022.0155 Text en Copyright © 2023 by Korean Society of Spine Surgery https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Chen, Stephen Ryan
Munsch, Maria Amelia
Chen, Joseph
Couch, Brandon Keith
Wawrose, Richard Alan
Oyekan, Anthony Abimbade
Adjei, Joshua
Donaldson, William F.
Lee, Joon Yung
Shaw, Jeremy DeWitt
Spine Fractures of Patients with Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis: Fracture Severity and Injury-Related Mortality at a Level I Trauma Center
title Spine Fractures of Patients with Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis: Fracture Severity and Injury-Related Mortality at a Level I Trauma Center
title_full Spine Fractures of Patients with Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis: Fracture Severity and Injury-Related Mortality at a Level I Trauma Center
title_fullStr Spine Fractures of Patients with Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis: Fracture Severity and Injury-Related Mortality at a Level I Trauma Center
title_full_unstemmed Spine Fractures of Patients with Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis: Fracture Severity and Injury-Related Mortality at a Level I Trauma Center
title_short Spine Fractures of Patients with Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis: Fracture Severity and Injury-Related Mortality at a Level I Trauma Center
title_sort spine fractures of patients with ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis: fracture severity and injury-related mortality at a level i trauma center
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10300891/
https://www.ncbi.nlm.nih.gov/pubmed/36775833
http://dx.doi.org/10.31616/asj.2022.0155
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