How do fractures affect patients with ankylosing spondylitis (AS) and undifferentiated spondyloarthropathy (USpA)?

Updated: Sep 03, 2019
  • Author: Lawrence H Brent, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

The most serious complication related to AS is a vertebral fracture. Vertebral fractures associated with AS are most common in the cervical spine and are usually the result of a minor fall. For a patient with advanced AS, minor trauma is capable of producing an unstable spinal injury with the risk of neurologic injury or death.

Vertebral fractures are more likely to produce spinal instability in an individual with AS than in an individual without AS, because in advanced AS, the fracture occurs as in a long-bone fracture. The fracture disrupts not only the bony elements but also the ligamentous supports that have become ossified. Without the ligamentous support, the spine becomes grossly unstable, and this instability can lead to severe neurologic injury, including paralysis and death.


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