文章基本信息

标题：Spontaneous intraoperative lumbar fracture leading to an unexpected correction in ankylosing spondylitis corrective surgery – a case report
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作者：Christoph-Eckhard Heyde ; Stefan Glasmacher ; Nicolas H. von der Höh 等
期刊名称：GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
印刷版ISSN：2193-8091
电子版ISSN：2193-8091
出版年度：2020
卷号：9
页码：26-31
DOI：10.3205/iprs000148
出版社：German Medical Science
摘要：Severe kyphotic deformity in patients with ankylosing spondylitis can be corrected surgically to achieve a better spinal alignment and an improved visual axis. Different surgical techniques are used today depending on the extent of ossification and the degree of kyphosis. It is well known that the underlying disease leads to distinct biomechanical changes of the spinal column causing an increased fracture risk especially in case of minor trauma. This includes manipulations during surgical procedures as well as during the required perioperative measures. We present the case of a 45-year-old patient with severe global kyphotic deformity due to ankylosing spondylitis. During the elective corrective surgery (pedicle subtraction osteotomy at the level of L3) the patient sustained a spontaneous fracture at L2/3. This fortunately nondisplaced wedge-shaped fracture in the sense of a Smith-Peterson osteotomy led to a spontaneous correction of the kyphosis. The described unexpected event required a change in the surgical strategy. Correction could be achieved using a two-stage surgical procedure without further drawbacks for the patient. This case report stresses the need of particular attention regarding the increased susceptibility of the spinal column in case of ankylosing spondylitis.
关键词：ankylosing spondylitis; spine; corrective surgery; spontaneous fracture