Evidence map›Paper›PMID 37022510›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023

Cervical spine fractures in ankylosing spondylitis patients: an analysis of the presentation and clinical results of 110 surgically managed patients in two spine centers.

Mohamed Alhashash, Mootaz Shousha, Christoph-Eckhard Heyde, Nicolas Heinz von der Höh

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

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7citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Mohamed AlhashashSpine Surgery Department, Zentralklinik Bad Berka, Bad Berka, Germany. hashmf1@yahoo.com.ORCID http://orcid.org/0000-0001-7592-1419
Mootaz ShoushaSpine Surgery Department, Zentralklinik Bad Berka, Bad Berka, Germany.
Christoph-Eckhard HeydeDepartment of Orthopaedic, Trauma and Plastic Surgery, University Hospital Leipzig, Liebigstr. 18, 04103, Leipzig, Germany.
Nicolas Heinz von der HöhDepartment of Orthopaedic, Trauma and Plastic Surgery, University Hospital Leipzig, Liebigstr. 18, 04103, Leipzig, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn this work, a two-center study was performed to study the clinical presentation of cervical spine fractures in ankylosing spondylitis (AS) patients and assess the surgical management of these fractures.

methodsA retrospective analysis of prospectively collected data in two level-1 spine surgery centers was performed. Both spine centers have a standard database for all admitted patients. Inclusion criteria were surgically treated AS with cervical spine fracture diagnosis (from C1 to Th3) and postoperative follow-up minimum of 12 months.

resultsOne hundred ten patients (105 male/5 female) were included. The mean age was 62 ± 10 years. The mean time between trauma and surgery was 49 ± 42 days. There was a history of mild trauma in 72 patients (65.4%). The clinical presentation was a pain in all patients. Twenty-seven (24.6%) had a neurological deficit at admission. The most common fracture level was C6/7 in 63 patients (57.23%). The VAS was 7 ± 1, and NDI was 34 ± 8 in the preoperative assessment. The mean preoperative kyphosis angle was 48 ± 26° between C2 and C7. Positioning and preparing of the patients on the operation table took a mean of 57 ± 28 min. The surgical approach was dorsal in 59 patients (53.6%), combined in 45 patients (40.9%), and ventral in 6 patients (6,5%). The mean number of the fixed levels was 6 ± 2 levels. Intraoperative complications occurred in 9 patients (8.2%). Postoperative Cobb angle improved to a mean of 17 ± 9 degrees. Neurological improvement occurred in 20/27 patients. In 12 patients, the recovery was complete. The mean postoperative follow-up was 46 ± 18 months. VAS improved to 3 ± 1, and NDI improved to 14 ± 6 at the last postoperative visit. The improvement was clinically significant (p = 0.01 and 0.00, respectively).

conclusionHigh suspicion of cervical spine fractures is necessary for patients with AS. CT and MRI images are necessary to rule out cervical spine fractures in AS patients, especially to detect occult fractures. Surgical treatment is safe, and the posterior approach with long-segment fusion is the approach of choice in this group of patients.

Indexed as

Fractures, BoneSpinal FracturesSpondylitis, AnkylosingAgedCervical VertebraeFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeAnkylosing spondylitisCervical fracturesDelayed diagnosisNeurological deficitPosterior approachSurgical treatment

Identifiers

PMID37022510

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.