Jin-Wan Kim; Young-Chul Ko; Chul-Young Jung; Il-Soo Eun; Young-June Kim; Chang-Kyu Kim

doi:10.12671/jkfs.2012.25.1.77

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Case Report
Treatment of a 3rd Lumbar Vertebra Translational Injury Combined with Incomplete Cauda Equina Syndrome in Ankylosing Spondylitis: A Case Report: Jin-Wan Kim, M.D., Young-Chul Ko, M.D., Chul-Young Jung, M.D., Il-Soo Eun, M.D., Young-June Kim, M.D., Chang-Kyu Kim, M.D.; Journal of the Korean Fracture Society 2012;25(1):77-81.
DOI: https://doi.org/10.12671/jkfs.2012.25.1.77
Published online: January 31, 2012

Department of Orthopedic Surgery, Busan Medical Center, Busan, Korea.

Address reprint requests to: Young-Chul Ko, M.D. Department of Orthopedic Surgery, Busan Medical Center, 1330, Geoje 2-dong, Yeonje-gu, Busan 611-072, Korea. Tel: 82-51-607-2862, Fax: 82-51-507-3001, drgo1973@nate.com

• Received: August 25, 2011 • Revised: November 23, 2011 • Accepted: December 9, 2011

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Abstract
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Abstract

Ankylosing spondylitis is a rheumatic disease in which mainly the spinal and sacroiliac joints are affected. Patients with ankylosing spondylitis are at significant risk for spinal fracture when exposed to even minor trauma. Most spinal fractures with ankylosing spondylitis occur in the cervical spine, whereas spinal fractures in thoracic or lumbar spine are rare, especially in the lower lumbar spine. Furthermore, neurologic symptoms in cases of lower lumbar spine fracture are rarer than in cases of cervical and thoracic spinal fracture. We have experienced a case of translation injury of the 3rd lumbar vertebra accompanied by incomplete cauda equine syndrome in ankylosing spondylitis and the authors gained good clinical results with surgical treatment. We have reported here on this case and have included a review of the relevant literature.
Key words: Ankylosing spondylitis, Incomplete cauda equina syndrome, Translational injury, Postero-lateral fusion

REFERENCES

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9. Shen FH, Samartzis D. Successful nonoperative treatment of a three-column thoracic fracture in a patient with ankylosing spondylitis: existence and clinical significance of the fourth column of the spine. Spine (Phila Pa 1976), 2007;32:E423-E427.
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Fig. 1

(A, B) Preoperative anteroposterior view and lateral view show third lumbar vertebrae translational injury traversing across all three columns in a 55-year-old man with ankylosing spondylitis.

Fig. 2

(A, B) Preoperative T2 weighted sagittal and axial MRI show translational injury in the L3 vertebral body with canal encroachment and posterior longitudinal ligament tear in the posterior column.

Fig. 3

(A~D) At a postoperative 12 weeks, anteroposterior and lateral plain X-ray show correction of height loss and anteroposterior and lateral 3D reconstruction image shows maintenance of reduced fracture.

Fig. 4

(A, B) At a postoperative 12 months, anteroposterior and lateral plain X-ray show reduced kyphosis and fracture.

Figure & Data

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Treatment of a 3rd Lumbar Vertebra Translational Injury Combined with Incomplete Cauda Equina Syndrome in Ankylosing Spondylitis: A Case Report

J Korean Fract Soc. 2012;25(1):77-81. Published online January 31, 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.1.77

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Treatment of a 3rd Lumbar Vertebra Translational Injury Combined with Incomplete Cauda Equina Syndrome in Ankylosing Spondylitis: A Case Report

Fig. 1 (A, B) Preoperative anteroposterior view and lateral view show third lumbar vertebrae translational injury traversing across all three columns in a 55-year-old man with ankylosing spondylitis.

Fig. 2 (A, B) Preoperative T2 weighted sagittal and axial MRI show translational injury in the L3 vertebral body with canal encroachment and posterior longitudinal ligament tear in the posterior column.

Fig. 3 (A~D) At a postoperative 12 weeks, anteroposterior and lateral plain X-ray show correction of height loss and anteroposterior and lateral 3D reconstruction image shows maintenance of reduced fracture.

Fig. 4 (A, B) At a postoperative 12 months, anteroposterior and lateral plain X-ray show reduced kyphosis and fracture.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Treatment of a 3rd Lumbar Vertebra Translational Injury Combined with Incomplete Cauda Equina Syndrome in Ankylosing Spondylitis: A Case Report