Juan Ignacio Cirillo T1,2, Marcos Gimbernat R1, Ignacio Farías M3, Gabriel Hernández Vargas4, Alejandro Urzúa B1, José Vicente Ballesteros P1,5. 1. Department of Orthopedics - Division of Spine Surgery, Hospital del Trabajador, Santiago, Chile. 2. Clínica Universidad de los Andes, Santiago, Chile. 3. Department of Orthopedics - Spine Surgery, AOSpine Center Chile - Hospital del Trabajador, Santiago, Chile. 4. Department of Orthopedics - Spine Surgery, AOSpine Center Chile - Hospital del Trabajador, Santiago, Chile. ghernan.md@gmail.com. 5. Universidad Nacional Andrés Bello, Santiago, Chile.
Abstract
STUDY DESIGN: Case series study. PURPOSE: To describe demographic metrics, and clinical and radiographical outcomes of surgical treatment in patients with ankylosed spine (ASP) such as diffuse idiopathic skeletal hyperostosis (DISH) or ankylosing spondylitis (AS) and non-ankylosed spines (NAS) suffering from hyperextension-distraction spine fractures. METHODS: Patients diagnosed with hyperextension-distraction fractures between 2012 and 2020 were identified. A retrospective analysis of clinical and surgical data was performed. Similarities between patients with ASP and NAS were evaluated by Fisher's exact test. RESULTS: Of the 22 patients, 13 had ASP (10 patients with DISH, 3 AS) and nine NAS. Most of these injuries involved the thoracolumbar spine (45.4%). All patients with NAS presented some sign of spondylosis: facet joint degeneration, intervertebral osteochondrosis, and anterolateral osteophytes. None of the patients with NAS and 30.7% with ASP suffered low-energy mechanisms (p = .11). All the patients with NAS and 61% of the patients with ASP had associated injuries (p = .04). On average, the instrumented levels were four (range, 2-6), achieving a fusion rate of 94.7% in all groups. Most of the ASP and NAS presented post-operative complications respectively (p = .65). CONCLUSION: Hyperextension-distraction spine fractures are not unique in ASP. In patients with spondylosis and high-energy accidents, we should suspect those fractures and rule out associated injuries, fractures in other vertebral segments, and acute spinal cord injury. The four-level instrumentation achieved an effective fusion rate in all patients.
STUDY DESIGN: Case series study. PURPOSE: To describe demographic metrics, and clinical and radiographical outcomes of surgical treatment in patients with ankylosed spine (ASP) such as diffuse idiopathic skeletal hyperostosis (DISH) or ankylosing spondylitis (AS) and non-ankylosed spines (NAS) suffering from hyperextension-distraction spine fractures. METHODS: Patients diagnosed with hyperextension-distraction fractures between 2012 and 2020 were identified. A retrospective analysis of clinical and surgical data was performed. Similarities between patients with ASP and NAS were evaluated by Fisher's exact test. RESULTS: Of the 22 patients, 13 had ASP (10 patients with DISH, 3 AS) and nine NAS. Most of these injuries involved the thoracolumbar spine (45.4%). All patients with NAS presented some sign of spondylosis: facet joint degeneration, intervertebral osteochondrosis, and anterolateral osteophytes. None of the patients with NAS and 30.7% with ASP suffered low-energy mechanisms (p = .11). All the patients with NAS and 61% of the patients with ASP had associated injuries (p = .04). On average, the instrumented levels were four (range, 2-6), achieving a fusion rate of 94.7% in all groups. Most of the ASP and NAS presented post-operative complications respectively (p = .65). CONCLUSION: Hyperextension-distraction spine fractures are not unique in ASP. In patients with spondylosis and high-energy accidents, we should suspect those fractures and rule out associated injuries, fractures in other vertebral segments, and acute spinal cord injury. The four-level instrumentation achieved an effective fusion rate in all patients.
Authors: Najib E El Tecle; Kingsley O Abode-Iyamah; Patrick W Hitchon; Nader S Dahdaleh Journal: Clin Neurol Neurosurg Date: 2015-10-23 Impact factor: 1.876
Authors: Charbel D Moussallem; Brandon A McCutcheon; Michelle J Clarke; Quanqi Cui; Bradford L Currier; Michael J Yaszemski; Paul M Huddleston; Peter S Rose; Brett Freedman; Mark B Dekutoski; Mohamad Bydon; Ahmad Nassr Journal: J Clin Neurosci Date: 2016-03-30 Impact factor: 1.961