An Occult Fracture in a Ankylosing Spondylitis Patient

ABSTRACT

A61-year-old head-injured patient exhibited acute onset of paraplegia during hospital in-care. Review of radiographs showed an occult linear transverse fracture line between the T11 and T12 vertebrae. An MRI scan performed after paraplegia showed compression of the spinal cord by a bony fragment. This case report presents a rare but devastating complication of an occult fracture at the T-L junction in patient with ankylosing spondylitis which was considered less significant due to more severe head injury. Thorough clinical and roentgenographic examination of the entire vertebral column is recommended in patients with ankylosing spondylitis who have sustained injury. Even if minor spinal trauma occurs in such clinical setting, the condition should be managed as a spinal fracture with potentially serious neurologic complications.