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Spinal cord injury and spinal fracture in patients with ankylosing spondylitis

BACKGROUND: Spinal cord injury (SCI) and spinal fracture are major complications in patients with ankylosing spondylitis (AS) who sustain spinal trauma. The purpose of this study was to investigate the incidence, predictors, and sequelae of spinal trauma in patients with AS. METHODS: This retrospect...

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Autores principales: Tu, Po-Hsun, Liu, Zhuo-Hao, Yeap, Mun-Chun, Liu, Yu-Tse, Li, Ying-Ching, Huang, Yin-Cheng, Lin, Tzu-Min, Chen, Ching-Chang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063196/
https://www.ncbi.nlm.nih.gov/pubmed/35501709
http://dx.doi.org/10.1186/s12873-022-00635-3
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author Tu, Po-Hsun
Liu, Zhuo-Hao
Yeap, Mun-Chun
Liu, Yu-Tse
Li, Ying-Ching
Huang, Yin-Cheng
Lin, Tzu-Min
Chen, Ching-Chang
author_facet Tu, Po-Hsun
Liu, Zhuo-Hao
Yeap, Mun-Chun
Liu, Yu-Tse
Li, Ying-Ching
Huang, Yin-Cheng
Lin, Tzu-Min
Chen, Ching-Chang
author_sort Tu, Po-Hsun
collection PubMed
description BACKGROUND: Spinal cord injury (SCI) and spinal fracture are major complications in patients with ankylosing spondylitis (AS) who sustain spinal trauma. The purpose of this study was to investigate the incidence, predictors, and sequelae of spinal trauma in patients with AS. METHODS: This retrospective study included patients with AS who were admitted for spinal trauma between January 1, 2006, and June 30, 2016. The study compared clinical outcomes of patients between group 1: SCI alone, group 2: spinal fracture alone (no SCI), and group 3: both SCI and spinal fracture. RESULTS: Of the 6285 patients with AS admitted during the retrospective study period, only 105 suffered from spinal trauma and were enrolled in the study. Case number in group 1, 2, and 3 was 11(10.48%), 45(42.85%), and 49(46.67%), respectively. Among the patients with spinal fractures, 52.1% had SCI. Bamboo spine was significantly more prevalent in the fracture group than in the nonfracture group (78.7% vs. 36.4%; P = 0.006). Patients with SCI had more instances of subluxation or dislocation (48.3% vs. 8.9%; P < 0.001) and more cases of spinal epidural hematoma (SEH; 21.7% vs. 2.2%; P = 0.003) than patients without SCI. The rate of delayed diagnosis for spinal fracture was 31.4%, with one-third of patients developing delayed SCI. Among the patients with incomplete SCI, 58.3% achieved neurological improvement after treatment (P = 0.004). CONCLUSIONS: Patients with AS and bamboo spine at radiograph had a higher rate of spinal fracture, which may be an important factor in SCI in patients with AS. Spinal fractures involving the C3–C7 region, subluxation or dislocation, severe spinal fracture, and SEH were found to be predictive of SCI, and SCI in patients with AS resulted in higher mortality and complication rates.
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spelling pubmed-90631962022-05-04 Spinal cord injury and spinal fracture in patients with ankylosing spondylitis Tu, Po-Hsun Liu, Zhuo-Hao Yeap, Mun-Chun Liu, Yu-Tse Li, Ying-Ching Huang, Yin-Cheng Lin, Tzu-Min Chen, Ching-Chang BMC Emerg Med Research Article BACKGROUND: Spinal cord injury (SCI) and spinal fracture are major complications in patients with ankylosing spondylitis (AS) who sustain spinal trauma. The purpose of this study was to investigate the incidence, predictors, and sequelae of spinal trauma in patients with AS. METHODS: This retrospective study included patients with AS who were admitted for spinal trauma between January 1, 2006, and June 30, 2016. The study compared clinical outcomes of patients between group 1: SCI alone, group 2: spinal fracture alone (no SCI), and group 3: both SCI and spinal fracture. RESULTS: Of the 6285 patients with AS admitted during the retrospective study period, only 105 suffered from spinal trauma and were enrolled in the study. Case number in group 1, 2, and 3 was 11(10.48%), 45(42.85%), and 49(46.67%), respectively. Among the patients with spinal fractures, 52.1% had SCI. Bamboo spine was significantly more prevalent in the fracture group than in the nonfracture group (78.7% vs. 36.4%; P = 0.006). Patients with SCI had more instances of subluxation or dislocation (48.3% vs. 8.9%; P < 0.001) and more cases of spinal epidural hematoma (SEH; 21.7% vs. 2.2%; P = 0.003) than patients without SCI. The rate of delayed diagnosis for spinal fracture was 31.4%, with one-third of patients developing delayed SCI. Among the patients with incomplete SCI, 58.3% achieved neurological improvement after treatment (P = 0.004). CONCLUSIONS: Patients with AS and bamboo spine at radiograph had a higher rate of spinal fracture, which may be an important factor in SCI in patients with AS. Spinal fractures involving the C3–C7 region, subluxation or dislocation, severe spinal fracture, and SEH were found to be predictive of SCI, and SCI in patients with AS resulted in higher mortality and complication rates. BioMed Central 2022-05-02 /pmc/articles/PMC9063196/ /pubmed/35501709 http://dx.doi.org/10.1186/s12873-022-00635-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Tu, Po-Hsun
Liu, Zhuo-Hao
Yeap, Mun-Chun
Liu, Yu-Tse
Li, Ying-Ching
Huang, Yin-Cheng
Lin, Tzu-Min
Chen, Ching-Chang
Spinal cord injury and spinal fracture in patients with ankylosing spondylitis
title Spinal cord injury and spinal fracture in patients with ankylosing spondylitis
title_full Spinal cord injury and spinal fracture in patients with ankylosing spondylitis
title_fullStr Spinal cord injury and spinal fracture in patients with ankylosing spondylitis
title_full_unstemmed Spinal cord injury and spinal fracture in patients with ankylosing spondylitis
title_short Spinal cord injury and spinal fracture in patients with ankylosing spondylitis
title_sort spinal cord injury and spinal fracture in patients with ankylosing spondylitis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063196/
https://www.ncbi.nlm.nih.gov/pubmed/35501709
http://dx.doi.org/10.1186/s12873-022-00635-3
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