gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Morbidity and mortality and surgical strategy in patients with ankylosing spondylitis spine fractures

Meeting Abstract

Search Medline for

  • Elisabeth Török - Neurochirurgische Klinik, Klinikum rechts der Isar, Technische Universität München
  • Jens Gempt - Neurochirurgische Klinik, Klinikum rechts der Isar, Technische Universität München
  • Bernhard Meyer - Neurochirurgische Klinik, Klinikum rechts der Isar, Technische Universität München
  • Yu-Mi Ryang - Neurochirurgische Klinik, Klinikum rechts der Isar, Technische Universität München

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 148

doi: 10.3205/14dgnc543, urn:nbn:de:0183-14dgnc5436

Published: May 13, 2014

© 2014 Török et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Spine fractures in patients with ankylosing spondylitis often occur after minor trauma. Moribund patients and complex surgical procedures make the treatment of these patients a challenging task. Only few series are published and treatment guidelines are missing.

Method: Retrospective review of our clinical database for patients with ankylosing spondylitis who underwent surgical treatment for spine fractures between 03/2008 and 10/2013. Hospital-/ICU-stay, co-morbidities, peri-/postoperative complications and surgical strategy were assessed.

Results: 19 pts (12 m /7 f; mean age 74 yrs, range 47 – 90) were operated for traumatic Bechterew fractures (11 cervical, 7 thoracic, 1 lumbar). 16/19 (84%) pats. suffered from more than 1 relevant co-morbidity prior to trauma. Mean hospital stay was 27 ± 17 d (6 – 70). 12/19 (63%) pats. needed ICU treatment (mean stay 24 ± 17 d, range 1 – 51) due to medical deterioration. There were different operating strategies in fractures of the cervical spine: In 10/11 cases a 360 ° fusion was applied (6 x anterior – posterior, 4 x posterior – anterior, in 8/11 cases 2-staged with a mean interval of 6 ± 4 d (1 – 14). 1 pat. received mere dorsal instrumentation. Preexisting poor medical condition and clinical deterioration obviated a secondary ventral procedure. 5/8 (62%) of the pats. with thoracic / lumbar fractures received a 360° fusion with primary posterior stabilization ± laminectomy and secondary ventral corpectomy during the same hospital stay. 3 pats. received mere posterior instrumentation. 9/19 pats. (47%) had preoperative neurological deficits of whom 2/9 pats. improved, 6/9 pats. were unchanged after surgery. 5 intraoperative complications occurred. Revision surgeries were necessary in 3 pats. 9 (47%) pats. experienced medical complications or neurological deterioration (4 pats.) prior to surgery. These pats. were hospitalized for a significantly longer time period (40 ± 17 d vs. 18 ± 9 d, p < 0.05). The duration of ICU-stay was also significantly longer in these pats. (30 ± 15 d vs. 2 ± 3 d, p < 0.05). 41 medical complications occurred in 12/19 pts (63%). 2/19 pats. (10%) of these died during hospital stay from severe medical complications.

Conclusions: Morbidity-rate is very high in patient with ankylosing spondylitis spine fractures with long hospital and ICU-stay and high medical expenses. Surgery-associated complications were rare.