Ankylosing spondylitis: special considerations and clinical outcomes in surgical management of spinal fractures, case series and analysis of twenty patients

Ankylosing Spondylitis (AS) is a systemic inflammatory disease that involves the axial skeleton the most. It causes ascending inflammation and, thus, rigidity in the spinal column, from the sacroiliac joint to the cervical region. Spinal column deformities, besides vulnerability to trauma, alter the patients' quality of life and put their neural elements a great risk. In this study, we reviewed data of twenty AS patients who underwent spinal surgery due to trauma and spinal deformity due to AS, over 12 years in our center. Spinal radiologic indices, besides clinical evaluation of quality of life and neurologic status, were reviewed and mentioned. AS patients who were operated due to severe deformity and instability, correction of spinopelvic indices correlated with significant improvement in their quality of life and pain scores. Among those who were operated due to fracture and/or neurologic damage, clinical and neurologic improvement was significant. Spinal trauma and mal-alignment is AS, correlates with neurological compromise, and clinical symptoms such as pain and gait disturbance. Near complete correction of these indices improves patients' quality of life. Traumatic spinal fractures in AS, should be considered unstable unless otherwise proved. Meticulous surgical stabilization in such cases usually indicates.