KẾT QUẢ PHẪU THUẬT CHẤN THƯƠNG CỘT SỐNG Ở BỆNH NHÂN VIÊM CỘT SỐNG DÍNH KHỚP

Abstract

SPONDYLITIS

Objective: In patients with ankylosing spondylitis, the risk of fracture is very high, even after minor trauma. Spinal fracture in patients with ankylosing spondylitis can lead to severe sequelae. We conducted this study to evaluate the outcomes of spinal fracture surgical treatment in patients with ankylosing spondylitis. Method: A retrospective cross-sectional descriptive study conducted on patients diagnosed with spinal fracture and ankylosing spondylitis, treated surgically at the Spine Surgery Department of Viet Duc University Hospital from June 2020 to August 2022. Results: Our study included 14 patients, all of whom were male. The average age was 59.8 years (ranging from 37 to 71 years). The average follow-up period after surgery was 10.4 months. Regarding the type of fracture, 7 patients had fractures passing through the intervertebral space (50%), while the rest had fractures through the vertebral body. All cases of cervical spine fractures in our study had fractures passing through the intervertebral space and underwent anterior interbody fusion with a fixation length of 2 vertebrae. For thoracic and lumbar spine fractures, the average fixation length was 4.56 vertebrae. Prior to surgery, 9 patients had neurological deficits (ASIA A-D, accounting for 64.3%), while 5 patients had intact neurological function (ASIA E, accounting for 35.7%). Four patients with incomplete paralysis before surgery showed improvement in neurological function, while 3 cases of complete paralysis had no improvement. Two cases of complete paralysis died post-surgery due to complications of pneumonia and respiratory failure at 1 month and 2 months after surgery, respectively. At the final follow-up, all patients achieved bone union on X-ray without any instrumentation failure. Conclusion: Spinal fractures in patients with ankylosing spondylitis can be easily overlooked if solely relying on X-ray imaging. Poor bone quality and altered biomechanics of the spine require surgeons to consider the length of fixation to avoid instrumentation failure. Surgical treatment results in improved neurological function in cases of incomplete spinal cord injury.