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Surgical Treatment of Spinal Pseudoarthrosis in Ankylosing Spondylitis

Author(s): Lih-Huei Chen | Feng-Chen Kao | Chi-Chien Niu | Po-Liang Lai | Tsai-Sheng Fu | Wen-Jer Chen

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 28;
Issue: 09;
Start page: 621;
Date: 2005;
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Keywords: ankylosing spondylitis | pseudoarthrosis | surgery.

Background: In ankylosing spondylitis (AS), the spine with osteoporotic changes is fragileand vulnerable to trauma. Patients may develop spinal pseudoarthrosis (SP),whose clinical features are usually misdiagnosed as a tuberculous infection.This study reports our experience with surgical treatment for SP in AS.Methods: Eight patients with AS and SP at the thoracolumbar area were treated surgicallyand followed-up for at least 3 years. All had persistent back pain andprogressive kyphosis. One patient had neurologic deficits preoperatively.Anterior debridement and interbody fusion followed by posterior stabilizationwere performed in all patients. A posterior corrective osteotomy wasadditionally done in 3 patients whose kyphotic angle exceeded 45°.Results: All patients with persistent back pain obtained significant pain relief postoperatively.On a visual analogue scale, there was an average improvement of43 points on the clinical scores. The patient with neurologic deficits showedimprovement after the operation. Solid bony fusion was achieved in an averageof 7.5 months, and correction of the kyphotic angle averaged 18.6°.Conclusions: Spinal pseudoarthrosis should be considered in patients with AS, and mustbe differentiated from tuberculous and other infections. The results of thisstudy show that pain relief and correction of the kyphotic deformity can beachieved by surgical treatment for ankylosing spondylitis complicated withpseudoarthrosis.
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