Risk factor analysis of vertebral fractures requiring surgery in patients with ankylosing spondylitis

Objectives This study aimed to determine the risk factors for vertebral fractures requiring surgery in patients with ankylosing spondylitis (AS).Methods We included 60 patients with AS diagnosed by using the modified New York criteria and who were treated in our department from April 2004 to March 2019. We evaluated age, sex, disease duration, C-reactive protein, erythrocyte sedimentation rate, ankylosed sacroiliac joint, bamboo spine, number of ankylosed vertebrae, and treatment (nonsteroidal anti-inflammatory drugs, prednisolone, conventional synthetic disease-modifying antirheumatic drugs, biological disease-modifying antirheumatic drugs, and spine surgery for vertebral fracture) at the final follow-up of the nonsurgical group and the preoperative follow-up of the surgical group.Results At the final follow-up, the mean age was 49 years, 46 patients (75%) were male, and the mean disease duration was 27 years. Additionally, 8 (13.3%) and 43 patients (71%) underwent surgical and medical treatments, respectively. The group of surgery for vertebral fracture had significantly higher C-reactive protein levels, which was also significantly associated with vertebral fracture surgery by multivariate analysis.Conclusions C-reactive protein was identified as a risk factor for vertebral fractures requiring surgery. Control of systemic inflammation in patients with AS may reduce the risk of vertebral fractures requiring surgery.