2020/11/24 by Christoph‐Eckhard Heyde, Heyde, Christoph-Eckhard, Stefan Glasmacher +5
Medicine · #610 Medical sciences #Fraktur #Korrekturosteotomie #Medicine #Morbus Bechterew #Pelvic and Acetabular Injuries #Scoliosis diagnosis and treatment #Spondyloarthritis Studies and Treatments #Wirbelsäule #ankylosing spondylitis #corrective surgery #spine #spontaneous fracture
paper · doi:10.3205/iprs000148
openalex publication_date 2020/11/24 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/19
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.