Fractures and Dislocations of the Spine Complicating Ankylosing Spondylitis

A REPORT OF SIX CASES

¹ From the Sections of Orthopaedic Surgery and Neurosurgery, Veterans Administration Center, Wadsworth, and the Section of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City

Six patients with Marie-Strümpell arthritis and recent fractures of the vertebral column, associated with neural involvement in five, were treated in a two-year period. Six other patients with this disease, seen during the same period for other reasons, showed evidence of old unrecognized vertebral fractures.

Fractures of the vertebral column in patients with Marie-Strümpell arthritis are relatively common after trauma and may be overlooked because of the history of chronic pain in the neck and back before the injury. Careful examination and adequate roentgenograms are mandatory in all patients with Marie-Strümpell disease who complain of pain in the spine after injury.

Conservative management is indicated for the treatment of patients without neural involvement. If there is progressive neural involvement, instability of the vertebral spine, or both, immediate exploration followed by fusion is indicated.

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