Vol.23 No.5

Case Report

Failure of conservative treatment for thoracic spine fracture in ankylosing spondylitis: delayed neurological deficit due to spinal epidural hematoma

Authors

Yasuchika Aoki1, 2 , Masatsune Yamagata2 , Yoshikazu Ikeda2 , Fumitake Nakajima2 , Arata Nakajima1 , Koichi Nakagawa1 , Seiji Ohtori3 , Tsutomu Inaoka4 , Kazuhisa Takahashi3

  • Department of Orthopaedic Surgery, Toho University, Sakura Medical Center, 654-1 Shimoshizu, Sakura Chiba, 285-8741, Japan
  • Department of Orthopaedic Surgery, Chiba Rosai Hospital, Chiba, Japan
  • Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
  • Department of Radiology, Toho University Sakura Medical Center, Chiba, Japan
Received:

19 March 2012

Accepted:

3 July 2012

Published online:

21 July 2012

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Abstract

Patients with ankylosing spondylitis (AS) are
prone to spinal fracture after even minor trauma. We report a
case of thoracic spinal fracture in a patient with AS who
developed a secondary neurological deficit due to delayed
diagnosis and prolonged conservative treatment. When the
neurological deficit occurred, the fractured segment showed
no displacement, but a spinal epidural hematoma was present.
Surgical treatment produced significant neurological
improvement, although incomplete paralysis persisted.

Key words

Ankylosing spondylitis, Delayed neurological deficit, Epidural hematoma, Spine fracture