Management of Acute Spinal Fractures in Ankylosing SpondylitisReportar como inadecuado




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ISRN RheumatologyVolume 2011 2011, Article ID 150484, 9 pages

Review ArticleDepartment of Orthopaedic Surgery, New Jersey Medical School, UMDNJ, 140 Bergen Street, ACC D-1610, Newark, NJ 07103, USA

Received 28 March 2011; Accepted 25 April 2011

Academic Editors: J. Bruges Armas and A. Kessel

Copyright © 2011 Saad B. Chaudhary et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ankylosing Spondylitis AS is a multifactorial and polygenic rheumatic condition without a well-understood pathophysiology Braun and Sieper 2007. It results in chronic pain, deformity, and fracture of the axial skeleton. AS alters the biomechanical properties of the spine through a chronic inflammatory process, yielding a brittle, minimally compliant spinal column. Consequently, this patient population is highly susceptible to unstable spine fractures and associated neurologic devastation even with minimal trauma. Delay in diagnosis is not uncommon, resulting in inappropriate immobilization and treatment. Clinicians must maintain a high index of suspicion for fracture when evaluating this group to avoid morbidity and mortality. Advanced imaging studies in the form of multidetector CT and-or MRI should be employed to confirm the diagnosis. Initial immobilization in the patient-s preinjury alignment is mandatory to prevent iatrogenic neurologic injury. Both nonoperative and operative treatments can be employed depending on the patient-s age, comorbidities, and fracture stability. Operative techniques must be individually tailored for this patient population. A multidisciplinary team approach is best with preoperative nutritional assessment and pulmonary evaluation.





Autor: Saad B. Chaudhary, Heidi Hullinger, and Michael J. Vives

Fuente: https://www.hindawi.com/



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