The Andersson lesion in ankylosing spondylitis DISTINGUISHING BETWEEN THE INFLAMMATORY AND TRAUMATIC SUBTYPES

被引:43
作者
Park, Y. -S. [1 ]
Kim, J. -H. [1 ]
Ryu, J. -A. [2 ]
Kim, T. -H.
机构
[1] Hanyang Univ, Coll Med, Guri Hosp, Dept Orthopaed Surg, Guri Si, Kyunggi Do, South Korea
[2] Hanyang Univ, Coll Med, Guri Hosp, Dept Radiol, Guri Si, Kyunggi Do, South Korea
来源
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME | 2011年 / 93B卷 / 07期
关键词
SPINAL PSEUDOARTHROSIS; DESTRUCTIVE LESIONS; SPONDYLODISCITIS; FUSION; DISEASE;
D O I
10.1302/0301-620X.93B7.26337
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
A number of causes have been advanced to explain the destructive discovertebral (Andersson) lesions that occur in ankylosing spondylitis, and various treatments have been proposed, depending on the presumed cause. The purpose of this study was to identify the causes of these lesions by defining their clinical and radiological characteristics. We retrospectively reviewed 622 patients with ankylosing spondylitis. In all, 33 patients (5.3%) had these lesions, affecting 100 spinal segments. Inflammatory lesions were found in 91 segments of 24 patients (3.9%) and traumatic lesions in nine segments of nine patients (1.4%). The inflammatory lesions were associated with recent-onset disease; a low modified Stoke ankylosing spondylitis spine score (mSASSS) due to incomplete bony ankylosis between vertebral bodies; multiple lesions; inflammatory changes on MRI; reversal of the inflammatory changes and central bony ankylosis at follow-up; and a good response to anti-inflammatory drugs. Traumatic lesions were associated with prolonged disease duration; a high mSASSS due to complete bony ankylosis between vertebral bodies; a previous history of trauma; single lesions; nonunion of fractures of the posterior column; acute kyphoscoliotic deformity with the lesion at the apex; instability, and the need for operative treatment due to that instability. It is essential to distinguish between inflammatory and traumatic Andersson lesions, as the former respond to medical treatment whereas the latter require surgery.
引用
收藏
页码:961 / 966
页数:6
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