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1.
Medicine (Baltimore) ; 99(19): e20055, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384469

RESUMO

INTRODUCTION: Sleep apnea-hypopnea syndrome (SAHS) is a multifactorial disease characterized by recurrent hypopnea or respiratory interruption during sleep, which causes intermittent hypoxemia, hypercapnia, and sleep structure disturbances. An association between ankylosing spondylitis (AS) and the type of SAHS has rarely been reported in the literature. Here, we present a case of SAHS in a patient with AS and discuss the possible mechanism underlying the type of SAHS. PATIENT CONCERNS: A 46-year-old man presented with a 15-year history of AS. He had been receiving sulfasalazine for symptomatic relief and had never been on immunosuppressive therapy. DIAGNOSIS: The patient was diagnosed with SAHS in addition to AS. INTERVENTIONS: We instituted treatment with methylprednisolone (5 mg, oral, daily), leflumomide (20 mg, oral, daily), bicyclol tablets (25 mg, oral, 3 times a day), and ursodeoxycholic acid tablets (10 mg/kg, oral, daily). The patient received etanercept (50 mg, sc, once a week) as his condition deteriorated. In addition, for management of SAHS symptoms, the patient received nasal continuous positive airway pressure (CPAP) during sleep. OUTCOMES: Six months after commencement of the treatment, the clinical manifestations of SAHS and AS had significantly improved. CONCLUSIONS: We hypothesize that patients with AS are prone to sleep apnea due to airway compression, central depression of respiration, abnormal inflammatory responses. Hence, careful assessment toward potential SAHS symptoms should be considered especially in patients with AS.


Assuntos
Apneia Obstrutiva do Sono/etiologia , Espondilite Anquilosante/complicações , Humanos , Masculino , Pessoa de Meia-Idade
2.
Medicine (Baltimore) ; 99(8): e19132, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080089

RESUMO

The osteoporosis was common complication of ankylosing spondylitis (AS), but it was frequently unrecognized in the initial stage of the disease. This study was to compare areal bone mineral density (BMD) of hip joints in early AS patients with that in healthy controls, to explore the progress of bone loss in cortex and spongiosa in early AS.Quantitative computed tomography (QCT) of hip was performed in 60 AS patients (modified New York criteria for AS, with grade 2 sacroiliitis in computed tomography) and 57 healthy controls. The QCT measurements of AS patients were compared with the measurements of healthy controls.The AS patients had lower areal BMD in cortical bone and total bone of proximal femur in early AS patients (P < .01), than the controls. But there were not significant different of areal BMD in spongiosa of proximal femur between the early AS patients and healthy controls. Strong correlations were found between body mass index BMI, areal BMD in cortical bone (rs = 0.410, P < .001; rs = 0.422, P < .001) and total bone (rs = 0.368, P < .001; rs = 0.266, P = .003) both in AS patients and healthy controls.The results indicate that osteopenia/osteoporosis is general in early stage of AS. What is more, the osteopenia/osteoporosis in cortex is earlier than in spongiosa of proximal femur in early AS.


Assuntos
Densidade Óssea/fisiologia , Articulação do Quadril/metabolismo , Osteoporose/etiologia , Espondilite Anquilosante/complicações , Adulto , Índice de Massa Corporal , Doenças Ósseas Metabólicas/complicações , Doenças Ósseas Metabólicas/diagnóstico por imagem , Feminino , Fêmur/anatomia & histologia , Fêmur/patologia , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Sacroileíte/classificação , Sacroileíte/complicações , Sacroileíte/diagnóstico por imagem , Espondilite Anquilosante/classificação , Tomografia Computadorizada por Raios X/métodos
3.
PLoS One ; 15(2): e0229273, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32084192

RESUMO

OBJECTIVE: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with mental illness. The risk of serious mental illness, including deliberate self-harm (DSH), in these conditions is not well known. We aimed to determine if RA or AS independently increases the risk for DSH. METHODS: We conducted retrospective, population-based cohort studies using administrative health data for the province of Ontario, Canada between April 1, 2002 and March 31, 2014. Individuals with incident RA (N = 53,240) or AS (N = 13,964) were separately matched 1:4 by age, sex, and year with comparators without RA or AS. The outcome was a first DSH attempt identified using emergency department data. We estimated hazard ratios (HR) and 95% confidence intervals (95% CI) for risk of DSH in RA and AS versus comparators, adjusting for demographic, clinical and health service utilization variables. RESULTS: Subjects with AS were significantly more likely to self-harm (crude incidence rate [IR] of 0.68/1,000 person years [PY] versus 0.32/1,000 PY in comparators), with an adjusted HR of 1.59 (95% CI 1.15 to 2.21). DSH was increased for RA subjects (IR 0.35/1,000 PY) versus comparators (IR 0.24/1,000 PY) only before (HR 1.43, 95% CI 1.16 to 1.74), but not after covariate adjustment (HR 1.07, 95% CI 0.86 to 1.33). CONCLUSIONS: AS carries an increased risk for DSH but no such risk was observed in RA. Further evaluation of at-risk AS subjects is needed, including the longitudinal effects of disease and arthritis therapies on self-harm behaviour. This will inform whether specific risk-reduction strategies for DSH in inflammatory arthritis are needed.


Assuntos
Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico , Comportamento Autodestrutivo/complicações , Espondilite Anquilosante/complicações , Espondilite Anquilosante/diagnóstico , Artrite Reumatoide/psicologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Espondilite Anquilosante/psicologia
5.
An Bras Dermatol ; 94(6): 751-753, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31789263

RESUMO

Lobular capillary hemangioma or pyogenic granuloma is a benign vascular tumor of the skin or mucous membranes. Most patients present a single lesion. It manifests clinically as an erythematous, friable, and fast-growing tumor. This report details a case with exuberant presentation in a patient with ankylosing spondylitis, using adalimumab. Factors triggering pyogenic granuloma are not well known. They may spontaneously regress, but most require treatment.


Assuntos
Adalimumab/uso terapêutico , Antirreumáticos/uso terapêutico , Granuloma Piogênico/patologia , Dermatopatias/patologia , Espondilite Anquilosante/tratamento farmacológico , Granuloma Piogênico/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Dermatopatias/etiologia , Espondilite Anquilosante/complicações , Fator de Necrose Tumoral alfa/antagonistas & inibidores
6.
Med Sci Monit ; 25: 9702-9711, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31851643

RESUMO

BACKGROUND This study was to investigate the correlation between osteoporosis and serum uric acid in ankylosing spondylitis (AS) patients, and to further identify potential factors that might be associated with osteoporosis in AS patients. MATERIAL AND METHODS We included 182 AS patients, consisted of 143 male patients and 39 female patients, who visited our hospital from January 1, 2014 to December 31, 2018. We used dual-energy x-ray absorptiometry to measure bone mineral density (BMD) of orthotopic lumbar vertebrae in patients with AS. The gender, age, disease duration, BMD, T-score, Z-score, uric acid, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), blood platelet (PLT), and status of treatment with biologics of the patients were collected. Then, the Spearman correlation coefficient and multivariate liner regression analysis were applied to identify the relationship between the factors and BMD, T-score, and Z-score in AS patients. RESULTS Male AS patients between the ages of 16 and 30 years old had a higher risk of osteoporosis (P<0.05). AS patients with uric acid value between 300-360 µmol/L had the highest BMD, T-score, and Z-score. The BMD had a positive correlation with age and disease duration (P<0.01) while had a negative correlation with PLT (P<0.05). BMD in AS patients with elevated ESR was significantly (P<0.05) lower than in AS patients with normal ESR. There were no significant differences in BMD between AS patients with elevated CRP and the patients with normal CRP and PLT. Treatment with TNFi (tumor necrosis factor alpha inhibitor) did not improve BMD in AS patients. CONCLUSIONS The relationship between uric acid and BMD in AS patients was observed as inverted "U"-type. Keeping uric acid within 300-360 µmol/L might be helpful in preventing AS patients from developing osteoporosis.


Assuntos
Grupo com Ancestrais do Continente Asiático , Osteoporose/sangue , Osteoporose/complicações , Espondilite Anquilosante/sangue , Espondilite Anquilosante/complicações , Ácido Úrico/sangue , Adolescente , Adulto , Antirreumáticos/uso terapêutico , Plaquetas/metabolismo , Sedimentação Sanguínea , Densidade Óssea , Proteína C-Reativa/metabolismo , Feminino , Humanos , Inflamação/sangue , Inflamação/patologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Osteoporose/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Espondilite Anquilosante/tratamento farmacológico , Espondilite Anquilosante/fisiopatologia , Adulto Jovem
8.
Orthopedics ; 42(6): e502-e506, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31505016

RESUMO

Ankylosing spondylitis is a progressive inflammatory disease that often involves the hip, causing deformities and dysfunction. Total hip arthroplasty (THA) may be used, but contracture of the hip joint in ankylosing spondylitis makes THA technically difficult and leads to poor efficacy. This retrospective study describes a novel 2-stage surgical treatment for ankylosing spondylitis of the hip and evaluates its efficacy relative to THA alone. Patients with ankylosing spondylitis and severe hip flexion contracture treated between 2011 and 2017 were assigned to either an experimental group or an age-matched control group (n=12 each) based on receiving, respectively, soft tissue release of the hip joint, femoral osteotomy, and supracondylar bone traction (stage I) and THA (stage II) or THA only. Clinical and radiological data included preoperative, postoperative, and follow-up Harris Hip Score and visual analog scale score, hip range of motion, femoral nerve injury, and heterotopic ossification. Both groups had significant corrections after surgery. At the final follow-up, the experimental group had significantly higher Harris Hip Scores and range of motion in extension compared with the control group, significantly more reduction in visual analog scale score, and no femoral nerve injury. The novel 2-stage surgery for patients with ankylosing spondylitis and severe hip flexion contracture is effective for restoring hip function and improving patients' quality of life, having fewer complications than traditional THA alone. [Orthopedics. 2019; 42(6):e502-e506.].


Assuntos
Artroplastia de Quadril/métodos , Contratura de Quadril/cirurgia , Articulação do Quadril/cirurgia , Prótese de Quadril , Osteotomia/métodos , Espondilite Anquilosante/cirurgia , Tração/métodos , Adulto , Feminino , Contratura de Quadril/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Qualidade de Vida , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Espondilite Anquilosante/complicações , Resultado do Tratamento
9.
Med Sci Monit ; 25: 6532-6538, 2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31471964

RESUMO

BACKGROUND The aim of this study was to analyze the clinical and radiological outcomes of modified closing-opening wedge osteotomy (mCOWO) for correcting kyphosis in ankylosing spondylitis (AS) patients. MATERIAL AND METHODS From April 2012 to April 2017, records of consecutive patients who underwent mCOWO were reviewed. The clinical and radiological outcomes were analyzed preoperatively, postoperatively, and at the most recent follow-up. RESULTS Eleven AS patients underwent mCOWO, with a mean follow-up of 19.4 months (range, 12-45 months). The average sagittal vertical axis (SVA) was corrected from 191.9 mm preoperatively to 75.9 mm postoperatively (P<0.05) and 78.9 mm at the most recent follow-up (P<0.05). The average correction angles at the osteotomy site were 44.5° postoperatively and 45.0° at the most recent follow-up (P>0.05). Sagittal translation (ST) occurred in 2 patients, and 5 mm was the maximum. There was no neurologic damage. Solid fusion was observed at the most recent follow-up in all patients. CONCLUSIONS Modified closing-opening wedge osteotomy (mCOWO) is an effective technique for correcting kyphosis in patients with AS.


Assuntos
Cifose/complicações , Cifose/cirurgia , Osteotomia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/cirurgia , Adulto , Feminino , Seguimentos , Humanos , Cifose/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Espondilite Anquilosante/diagnóstico por imagem , Resultado do Tratamento
10.
Zhonghua Yi Xue Za Zhi ; 99(29): 2276-2281, 2019 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-31434402

RESUMO

Objective: To investigate the change of esophageal length measured on computed tomography after C(7) pedicle subtraction osteotomy (PSO) for cervicothoracic kyphosis in ankylosing spondylitis (AS) patients and its clinical significance. Methods: Eight male AS patients with cervicothoracic kyphosis, who underwent PSO at C(7) level from December 2014 to November 2018 at Nanjing Drum Tower Hospital, were retrospectively reviewed. The mean age was (35±7) years (range, 26-49 years). The cervicothoracic kyphosis, C(2)-T(1) sagittal vertical axis (SVA) and angle of fusion levels (AFL) were measured on lateral cervical radiographs and chin-brow vertical angle (CBVA) was measured on clinical photographs preoperatively and postoperatively. Anterior height of the osteotomized vertebra (AHOV) and esophageal length from the lower endplate of C(6) to the inferior endplate of the lower instrumented vertebrae were measured on sagittal plane of reconstructed computed tomography preoperatively and postoperatively. Oswestry Disability Index (ODI), Neck Disability Index (NDI) and Numerical Rating Scale (NRS) were collected to evaluate the clinical outcomes. Results: The average follow-up duration was (15±9) months (range, 3-51 months). The average correction of cervicothoracic kyphosis, C(2)-T(1)SVA, AFL and CBVA was 35.9°±7.3°, (44.7±11.6) mm, 32.0°±4.8° and 38.1°±11.5°, respectively. The average reduction of AHOV was (5.6±1.6) mm. ODI was improved from 17±14 preoperatively to 13±10 at the final follow-up. The NDI before operation and at the final follow-up was 18±15 and 10±6, respectively. The preoperative NRS was 4.8±2.4, and it decreased to 1.0±1.2 at the final follow-up. The change of esophageal length showed significant correlation with the improvement of cervicothoracic kyphosis, C(2)-T(1)SVA, AFL and CBVA(r=0.84, 0.83, 0.83, 0.73, all P<0.05). Conclusions: The operation of C(7)PSO increases esophageal length after cervicothoracic kyphosis in AS patients. The esophageal elongation is closely related with changes of parameters measured on radiographs and clinical photographs. Spine surgeons should be aware of the potential risk of esophagus-related complications caused by esophagus lengthening after C(7)PSO.


Assuntos
Cifose , Espondilite Anquilosante , Adulto , Esôfago , Humanos , Cifose/complicações , Cifose/cirurgia , Masculino , Pessoa de Meia-Idade , Osteotomia , Estudos Retrospectivos , Espondilite Anquilosante/complicações , Vértebras Torácicas , Resultado do Tratamento
11.
BMJ Case Rep ; 12(8)2019 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-31401572

RESUMO

A 58-year-old man presented with a 2-month history of arthralgia and bilateral temporal region pain, and a 1-month history of fever. He had had refractory neck pain since his 20s. Reduced cervical and lumbar mobility was observed. Radiographs of cervical and thoracic vertebrae disclosed syndesmophytes. Pelvic radiographs showed sclerosis in the right sacroiliac joint and ankylosis in the left sacroiliac joint. MRI with contrast enhancement showed enthesitis in the upper extremities and enhancement in the bilateral temporal muscle, which indicated enthesitis of temporal muscle. He was diagnosed with ankylosing spondylitis based on the limitation in mobility of the lumbar spine and radiographic findings. To the best of our knowledge, this is the first report describing enthesitis of the temporal muscle. This case highlights that ankylosing spondylitis can be accompanied with enthesitis at the temporal muscle and fever of unknown origin at the initial presentation.


Assuntos
Entesopatia/etiologia , Febre de Causa Desconhecida/etiologia , Espondilite Anquilosante/complicações , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Articulação Sacroilíaca/diagnóstico por imagem , Articulação Sacroilíaca/patologia , Espondilite Anquilosante/diagnóstico , Músculo Temporal/diagnóstico por imagem , Músculo Temporal/fisiopatologia
12.
Turk J Gastroenterol ; 30(7): 599-604, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31290746

RESUMO

BACKGROUND/AIMS: The aim of the present study was to compare the demographic features and long-term outcomes of patients with inflammatory bowel disease (IBD) with or without ankylosing spondylitis (AS). MATERIALS AND METHODS: Among 1640 IBD (Crohn's disease and ulcerative colitis), 76 patients with IBD+AS were identified. The study group consisted of 76 patients with IBD with synchronous AS. The control group consisted of patients with only IBD, and those were selected according to their registry sequence number being the previous and next case to the diseased case with IBD+AS. The primary endpoint was to compare the rate of intestinal resections between both groups (IBD vs. IBD+AS). RESULTS: Among 76 patients with IBD+AS, 52 (68%) first presented with IBD, 11 (15%) with AS, and the remaining 13 (17%) had both diagnoses at the same time. The mean follow-up time was significantly longer in patients with IBD+AS (43.4 vs. 27.8 months; p=0.01). Twenty-two percent of patients with IBD and 14% of those with IBD+AS had an intestinal resection (p=NS). Biologic and systemic corticosteroid treatments were significantly more common among patients with IBD+AS (32% vs. 7% for biologics, p<0.0001 and 44% vs. 28% for corticosteroids, p=0.042). Age-sex-adjusted regression analysis for both groups disclosed IBD duration as the only independent predictor for resection (R2=0.178; p=0.016). CONCLUSION: The present study shows that up to 5% of patients with IBD may have AS. Patients with IBD+AS do not have a worse disease outcome than solo patients with IBD.


Assuntos
Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/terapia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/terapia , Adulto , Estudos de Casos e Controles , Demografia , Feminino , Humanos , Masculino , Turquia
13.
Medicine (Baltimore) ; 98(27): e16160, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277118

RESUMO

RATIONALE: Acquired pure red cell aplasia (PRCA) can be a secondary response to some autoimmune disorders. However, there is no data about the possibility of acquired PRCA being a secondary complication to ankylosing spondylitis (AS). PATIENT CONCERNS: A 42-year-old male who had a history of AS for 14 years. He got serious anemia 17 months ago. Bone marrow smear indicated PRCA. DIAGNOSE: He was diagnosed with acquired PRCA secondary to AS. INTERVENTION: The combination treatment of immunosuppressants with hematopoiesis stimuli was successful. OUTCOMES: The patient recovered from PRCA, and showed improvement in his AS. LESSONS: Acquired PRCA can be secondary to AS. Cyclosporine is effective in controlling AS arthritis syndrome and in addition to immunosuppressants, promotion of erythroid hematopoiesis is equally important.


Assuntos
Aplasia Pura de Série Vermelha/etiologia , Espondilite Anquilosante/complicações , Adulto , Ciclosporina/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Masculino , Aplasia Pura de Série Vermelha/diagnóstico , Espondilite Anquilosante/diagnóstico por imagem , Espondilite Anquilosante/tratamento farmacológico
14.
World Neurosurg ; 131: 27-31, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31356975

RESUMO

BACKGROUND: Ankylosing spondylitis (AS) is a systemic enthesopathy. In its presence, spinal fractures are often unstable. Acknowledging the preinjury level of kyphosis is key in the management of cervical fractures, and placement into a hard collar has been shown to result in life-threatening spinal cord complications. CASE DESCRIPTION: This report presents the unique case of a patient with AS who developed a unilateral C5 palsy after the application of a hard collar for a C5/6 fracture, to our knowledge the first such case presented to date. The patient subsequently went on to an anterior fixation and partially recovered from the C5 palsy/injury. After the case report is an examination of the currently available literature and evidence exploring the factors that may contribute to C5 palsy after the application of a collar for acute fracture in AS. CONCLUSIONS: We described the first case in the literature of a posttraumatic C5 palsy after application of a hard collar in AS. This report and literature review should act to underscore the importance of respecting a preexisting rigid kyphotic deformity in cervical fractures but also to stimulate further thoughts and investigations into what may contribute to a posttraumatic C5 palsy.


Assuntos
Discotomia , Aparelhos Ortopédicos/efeitos adversos , Radiculopatia/etiologia , Fraturas da Coluna Vertebral/terapia , Fusão Vertebral , Vértebras Cervicais , Humanos , Masculino , Pessoa de Meia-Idade , Radiculopatia/cirurgia , Fraturas da Coluna Vertebral/complicações , Espondilite Anquilosante/complicações
15.
World Neurosurg ; 130: e961-e970, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31302275

RESUMO

OBJECTIVE: To report the outcomes of severe kyphoscoliosis secondary to ankylosing spondylitis (AS) corrected with 3D-printed individualized guiding templates. METHODS: Computed tomography (CT) data of patients with severe kyphoscoliosis secondary to AS were used to reconstruct 3D models of the spine and to develop a surgical plan. An asymmetric wedge pedicle subtraction osteotomy (PSO) was simulated using medical computer design software. Before the actual surgery, continual surgical simulations were performed until the most suitable one was obtained, and personalized guiding templates were manufactured for the anticipated PSO. During operation, the osteotomy plane and trajectories for the pedicle screws were positioned by the designed patient-specific 3D-printed guiding templates. RESULTS: In this study, we reviewed 9 patients who underwent correction of kyphoscoliosis using a 3D-printed individualized guiding template and were followed for a median of 21.4 months (range, 9-36 months). The average correction at the site of osteotomy was 65.9°. No patient experienced severe complications, such as misplaced pedicle screws or neurologic complications. At the last follow-up, no patient exhibited implant dysfunction on radiography. CONCLUSIONS: Preoperative surgical simulation using 3D-printed templates is a viable technique that enables surgery to meet both patient- and surgeon-specific requirements for correction of severe thoracolumbar kyphoscoliosis. These 3D-printed templates can guide the performance of planned PSO to provide functional restoration of severe kyphoscoliosis secondary to AS.


Assuntos
Cifose/cirurgia , Medicina de Precisão/métodos , Impressão Tridimensional , Escoliose/cirurgia , Índice de Gravidade de Doença , Espondilite Anquilosante/cirurgia , Adulto , Feminino , Seguimentos , Humanos , Cifose/diagnóstico por imagem , Cifose/etiologia , Masculino , Escoliose/diagnóstico por imagem , Escoliose/etiologia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/diagnóstico por imagem , Resultado do Tratamento
16.
BMC Surg ; 19(1): 99, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31349822

RESUMO

BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects spine and paraspinal soft tissue. Ankylosing spondylitis is one of the causes of osteoporosis and patients with ankylosing spondylitis tend to have spinal fractures due to limited mobility and osteoporosis. In recent years, due to the increase in the number of patients with AS, patients with AS and thoracolumbar spine fractures have gradually increased. In the past 1 year, we have treated 3 cases of AS with thoracolumbar spine fractures via simple posterior internal fixation and this paper aims to report its clinic effect. CASE PRESENTATION: All the three patients selected had a history of ankylosing spondylitis for nearly 30 years, and one of them developed a thoracolumbar spine fracture after falling when he walked, and the other two developed a thoracolumbar spine fracture without any reason. They were hospitalized for "low back pain" and were diagnosed as fractures after careful physical examination and imaging examinations such as X-ray, CT, and MRI. After the preoperative preparation was completed, all the three patients underwent surgery with simple posterior internal fixation-reduction of the fracture and pedicle screw fixation via posterior approach. All the implants-pedicle screws and connecting rods-are made of titanium alloy. For postoperative management, we asked all the patients to stay in bed for 3 weeks after the operation, and then slowly move down with the help of crutches. Fracture healing and neurological function recovery were observed postoperatively. All the three patients recovered satisfactorily after surgery, and the follow-up confirmed that the fracture healed successfully after 3 months. CONCLUSIONS: The 3 patients included 2 men and 1 women. All the 3 patients recovered well after surgery, and the follow-up confirmed that the fracture healed successfully after 3 months. One man developed urination dysfunction after operation and recovered to normal 3 months after rehabilitation exercise.


Assuntos
Fixação Interna de Fraturas/métodos , Vértebras Lombares/lesões , Fraturas da Coluna Vertebral/cirurgia , Espondilite Anquilosante/complicações , Vértebras Torácicas/lesões , Feminino , Humanos , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Fraturas da Coluna Vertebral/etiologia , Vértebras Torácicas/cirurgia
19.
J Fam Pract ; 68(4): E1-E6, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31226181

RESUMO

It can often take years for patients with this condition to learn the true cause of their pain. But this guide to the work-up can help speed the diagnostic process.


Assuntos
Dor nas Costas/etiologia , Espondilite Anquilosante/complicações , Adulto , Dor nas Costas/diagnóstico , Dor nas Costas/terapia , Diagnóstico Diferencial , Humanos , Masculino , Encaminhamento e Consulta , Espondilite Anquilosante/diagnóstico , Espondilite Anquilosante/terapia
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